الفهرس 
Hepatocellular carcinomaOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is a major type of primary liver cancer and one of the most frequent human malignant neoplasms. It is estimated to cause more than a quarter of a million deaths each year throughout the world.
Because of the very high prevalence rate of HCV in the general Egyptian population, it accounts for most chronic liver disease and HCC cases in Egypt.
There is an evidence of the key role of the pleiotropic cytokine IL-6 in the process of liver damage and carcinogenesis. IL-6 is an intriguing cytokine to be studied in HCC patients.
The aims of the present work were to asses the value of serum level of interlukin-6 in patients with chronic liver disease and its level in patients with HCC, and to evaluate its sensitivity and specificity in comparison to AFP in diagnosis of HCC.
This study was done in co-operation between the Tropical Medicine Department in Faculty of Medicine (Ain Shams University) and Professor Doctor Yassin Abdel Gaffer Charity Center for Liver Disease and Research, in the period from August 2008 to June 2009.
The study was performed on three groups of Egyptian patients, Group I consisted of twenty five patients with chronic liver disease, their ages ranged between 25 and 65 years (mean 49.9 ± 10.2 years) included 21 male patients (84%) and 4 female patients (16%), Group II consisted of twenty five patients diagnosed as hepatocellular carcinoma (with serum alpha-fetoprotein above 200ng/ml) their age ranged between 46 and 72years (mean 55.9 ± 6.58 years) included 15 male patients (60%) and 10 female patients (40%) and Group III consisted of twenty five patients diagnosed as hepatocellular carcinoma (with serum alpha-fetoprotein below 200ng/ml) their age ranged between 39 and 72 years (mean 53.9 ± 10.3 years) included 19 male patients (76%) and 6 female patients (24%)
All patients were subjected to the following; careful history, thorough clinical examination and laboratory investigations including liver functions tests [liver enzymes (AST and ALT), total and direct bilirubin, serum albumin and INR], complete blood count, viral markers (HCVAb, HBsAg and HBcAb), Alph-fetoprotein and serum Interlukin-6 level. Abdominal ultrasound was done for all groups and spiral CT scan was done for group II and III for diagnosis of HCC.
The commonest presentation among our studied patients with HCC was loss of weight (88% in group II and 52% in group III) and jaundice (64% in group II and 68% in group III). Also the significant signs of liver cell failure that were detected on general examination of those patients were Jaundice (64% in group II and 68% in group III) and loss of weight (80% in group II and 44% in group III). Concerning the abdominal examination, hepatomegaly was the most significant finding in those patients (52% in group II and 64% in group III) (70%).
There was high statistically significant concerning positive HCV-Ab between the three studied groups (P< 0.01).
Regarding the comparison between the three studied groups as regards the mean IL-6 serum level. There was high significant difference between the three studied groups (P<0.01).
Concerning to the correlation between the mean IL-6 serum level and the Child-Pugh Staging System, the mean IL-6 in Child C (11.4±6.7) was higher than in Child A and B (9.31±6.75 and 9.7±5.8, respectively), but no significant difference between Class A, B and C.
Regarding the correlation between Number (single or multiple) of hepatic focal lesions by CT and the mean IL-6 in patients with HCC on top of cirrhotic liver, there was no significant relation between the number of HCC and the serum IL-6 level.
There was no significant relation between the presence of portal vein thrombosis in HCC patients and the mean IL-6 serum level.
The study revealed that the sensitivity & specificity of serum IL-6 in diagnosis of HCC at different cut of value. At cut-off values (6.05, 10.7 an 15.45 pg/ml), the sensitivity was (76%, 61%, and 55%, respectively) and the specificity was (80%, 100%, and 100%, respectively)
The beneficial diagnostic value of serum Interlukin-6 in diagnosis of patients with HCC is significantly increased when it is associated with AFP measurement. Interlukin-6 could not a candidate for noval tumor marker in detecting HCCs (with serum alpha-fetoprotein below 200ng/ml) because it shows less sensitivity than AFP.