الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Purpose: Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and a global health problem. It is often diagnosed at advanced stage where hopeless for effective therapies. Identification of more reliable biomarkers for early detection of HCC is urgently needed. circulating tumor cells (CTCs) represent a unique liquid biopsy carrying comprehensive biological information of the primary tumor. Herein, we sought to develop a novel score based on the combination of the most significant CTCs biomarkers with and routine laboratory tests for accurate detection of HCC.
Methods: This study conducted on approximately (42) patients with hepatocellular carcinoma on top HCV infection, in addition to (83) patients with HCV with cirrhotic liver, and (20) healthy persons as non-disease control group for comparison purpose. PBMCs were isolated from whole blood by a standard density gradient centrifugation procedure using Ficoll-Hypaque. Cytokeratin 18 (CK18), Cytokeratin 19 (CK19), EpCAM, Liver function, kidney function, albumin, platelets count, and α-fetoprotein were assayed.
Results: Areas under receiving operating curve (AUCs) were calculated and used for construction on novel score. A novel score named HCC-CTCs 1= AFP (U/L) × 0.08 - Albumin (g/dl) × 84 + CK 18 % × 2.9 + CK19 × 3.1- Platelets count (×109)/L× 0.75– 510. HCC-CTCs score produce AUC of 1 for differentiate patients with HCC from those with liver cirrhosis with sensitivity and specificity of a cut-off 0. Score 2= AFP (U/l) × 8.7 + CK18 (%) × 3.7 + CK19 (%) × 1.7 + EpCAM (%) × 0.15 – 341. Score = AFP (U/l) × 0.15 + CK18 (%) × 0.8 + CK19 (%) × 0.34 + EpCAM (%) × 0.12 – 40.
Conclusion: novel HCC-CTCs scores could replace AFP during screening of HCV patients and early detection of HCC.