الفهرس 
Hepatocellular CarcinomaOnly 14 pages are availabe for public view
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Abstract
H
epatocellular carcinoma (HCC) is a major cause of morbidity and mortality; it is the seventh most common cancer worldwide and the third leading cause of cancer-related deaths.
The most common risk factors of HCC are chronic hepatitis and liver cirrhosis caused by HBV and HCV infection. Defective cellular immune response toward viral antigens is one of the mechanisms for the development of HCC.
The diagnosis of HCC is mainly based on a combination of abdominal ultrasound, spiral CT and serum AFP level.
NKT (CD3+ CD 56+) cells are a population of T cells that share some characteristics with NK cells. These cells have immune modulatory effects and have an important role in anti-tumor immunity. It was proved that CD3+ CD56+ NKT cells derived from the liver exert vigorous cytotoxicity against HCC. It was reported that NKT cell activity was decreased in HCC, and the decreased NKT cell activity in cirrhotic patients has been related to increased incidence and invasiveness of HCC. It remains unclear how HCC, chronic viral hepatitis and liver cirrhosis reduces hepatic and peripheral NKT cells.
The aim of the present study was to elucidate the relationship between HCC and the percentages of NKT cells in the peripheral blood of these patients as a trial to evaluate its role in the disease pathogenesis. These data were compared to the data obtained from normal healthy individuals as a control group.
The current study was conducted at outpatient clinic and inpatients of Ain-Shams University Hospitals during the period between January 2013 and August 2013. A total of 40 patients along with 10 healthy controls with the same age and sex were enrolled. Subjects included in this study were classified into four groups: Group I (20 HCC patients), group II (10 chronic viral hepatitis patients), group III (10 liver cirrhosis patients) and group IV (10 control subjects).
The laboratory work was conducted at Clinical Pathology Department, Ain Shams University Hospitals.
All Subjects under study were subjected to full history taking, thorough clinical examination and Liver function tests: AST, ALT, Total bilirubin, Direct bilirubin, alkaline-phosphatase, total protein, serum albumin and AFP, and percentage of NKT cells were measured by flow cytometry using fluorescent labeled MoAb to CD3 and CD56.
Results of this study revealed that the percentages and absolute counts of NKT cells (CD3+CD56+) was significantly lower in patients of group I (HCC), group II (chronic hepatitis) and group III (liver cirrhosis) when compared to the subjects of group IV (Control Group).
There was no significant difference in the percentages and absolute counts of NKT cells between the first 3 groups (HCC, chronic viral hepatitis and liver cirrhosis) and each other.
Also, there was no statistical significant correlation between serum AFP levels and NKT cell percentages in all groups.
Correlative study within HCC, chronin hepatitis and cirrhotic groups revealed that NKT% had no significant correlation with all liver function tests.
In conclusion, this study revealed that there was no statistical significant difference in the percentages and absolute counts of NKT cells, between HCC group and the two other patient groups (chronic viral hepatitis and liver cirrhosis). So, NKT cells level in peripheral blood cannot be used as an early indicator of development of HCC in patients with chronic hepatitis or liver cirrhosis.
Also, the present study has identified that there is significant decrease in the percentages and absolute counts of NKT (CD3+ CD 56+) cells in HCC patients when compared to healthy subjects. This might be suggestive of the possible role of NKT (CD3+ CD 56+) cells the pathogenesis of HCC and a potential future use as immunotherapy.