الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The most common primary hepatic malignancy in adults is Hepatocellular carcinoma (HCC). In Egypt, it is the most common cancer in men and the second in women.
Liver cirrhosis develops mostly due to chronic hepatitis B (HBV) infection or chronic hepatitis C (HCV) infection, alcoholism, aflatoxin and NAFLD in most of the cases. HCC usually develops on top of liver cirrhosis and is usually diagnosed in advanced stage which limit its management options, thus identifying a novel biomarker of high accuracy to detect early HCC is critically needed.
Ultrasound assessment is used for HCC surveillance satisfactory pooled sensitivity, however it is operator dependent in addition, liver cirrhosis disrupts liver architecture, making the detection of small focal lesions more challenging. Alpha feto-protein (AFP) is the commonly used biomarker for HCC, however, its performance as a surveillance tool is not satisfactory mainly due to high false positive rate. Long non-coding ribonucleic acids (LncRNAs) are involved in the pathogenesis of malignant tumors and have been identified as promising biomarkers for cancer detection due to their stability in body fluids and measurability.
from lncRNAs that was found to be overexpressed in some malignancies; urothelial carcinoma associated (UCA-1) and the wd repeat containing, antisense to TP53 (WRAP53). This study was done to find their role as potential biomarkers in diagnosis of hepatocellular carcinoma.
The study included 90 subjects: 30 patients with liver cirrhosis and HCC, 30 patients with liver cirrhosis without HCC and 30 healthy controls. Subjects were recruited from the outpatient clinics and inpatient wards of Alexandria Main University Hospital and Medical Research Institute Hospital.
Full history was taken from all the patients specially regarding etiology of liver cirrhosis. All patients were subjected to complete general and abdominal examination especially for detection of signs of liver failure, hepatic encephalopathy, ascites, hepatomegaly, and splenomegaly. Abdominal ultrasonography was also performed to assess the presence of liver cirrhosis, focal hepatic lesions suggestive of HCC, ascites, splenomegaly as well as assessment of portal vein to detect portal vein thrombosis and portal hypertension.
Routine laboratory investigations were done including serum albumin, serum bilirubin, CBC, INR, liver enzymes, HCV Ab, HBs Ag and AFP. For patients in group I triphasic CT was done to diagnose hepatocellular carcinoma as well as assessment of portal vein to detect portal vein thrombosis. The HCC stage was assessed according to modified Barcelona Clinic Liver Cancer (BCLC) staging system while Child-Pugh classification was used to assess severity of liver disease in group I and II.