الفهرس 
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Abstract
Chronic kidney disease is a worldwide health problem that places a burden on global health care resources.
There has been an increased incidence of cancer in patients with end stage renal disease (ESRD) either due to immunodeficiency or exposure to environmental factors during hemodialysis or post transplantation immunosuppression.
Practice guidelines and/or standards for cancer screening that have been developed in the general population are not necessarily applicable to patients with ESRD. Considering the high importance and potential application in the early diagnosis of cancer, detection of tumor markers has received more and more attention
The role of tumor markers in cancer screening of ESRD is still controversial.
The aim of the present work was to evaluate the serum levels of five tumor markers: alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125), cancer antigen 19.9 (CA 19.9) and prostate specific antigen (PSA) in chronic hemodialysis patients and renal transplant recipients.
The study was conducted on forty-five individuals.
They were divided into three groups:
Group I:
Fifteen patients who were on chronic maintenance hemodialysis at El-Moassat Hospital, Alexandria University were prospectively selected and enrolled in the study.
Group II:
Fifteen patients who had done kidney transplantation and were following up in the transplantation outpatient clinic at Alexandria Main University Hospital.
Group Ш (control group):
Fifteen subjects of matched age and sex with no history of renal problems.
Exclusion Criteria:
6. Patients who had renal transplants or had been on maintenance hemodialysis for at least one month.
7. Patients with a prior history of cancer in any organ.
8. Patients suspicious of having malignant disease at the enrolment.
9. Patients with positive viral hepatitis markers.
10. Smokers.
All included patients and controls were subjected to:
I- History taking:
History was taken as regards demographic data, cause and history of chronic kidney disease (CKD), drug history, history of neoplasia, surgical history and habits.
II- Clinical examination.
III- Laboratory investigations:
Patients were subjected to the following laboratory investigations: (134)
1. Routine laboratory investigations (complete blood count, urea, creatinine, sodium, potassium).
2. Surface antigen of hepatitis B virus (HBsAg).
3. Hepatitis C antibody (HCV-Ab).
4. The following serum tumor markers that were detected by chemiluminescence technology:
• Alpha-fetoprotein (AFP).
• Carcinoembryonic antigen (CEA).
• Cancer antigen 19.9 (CA 19.9).
• Cancer antigen 125 (CA 125) which was measured only in female subjects.
• Prostate specific antigen (PSA) which was measured only in male subjects.
The study showed the following results:
• There was a highly significant statistical increase in CEA in subjects of group Ι than versus the other two groups.
• There was no statistical significant difference in the level of PSA between different groups.
• There was no statistical significant difference in the level of AFP between different groups.
• A significant statistical difference was observed in the level of CA125 between the three groups.
• A significant statistical difference was observed in the level of CA 19.9 between the three groups.
from the present study, we concluded the following:
• AFP and PSA are useful markers for cancer screening in chronic hemodialysis patients.
• Care must be taken while interpreting elevated concentrations of CEA, CA125 and CA19.9 in chronic hemodialysis patients.