الفهرس 
introductionOnly 14 pages are availabe for public view
 |  | from | 194 |  |  |
| | | from | 194 | | |
Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. In Egypt, the incidence of HCC has doubled in the past 10 years and it is now the second most incident and lethal cancer in men. It has been recognized that AFP has a low sensitivity in detection of HCC, and that AFP level often increases in the absence of HCC. Thus the identification of novel biochemical markers for HCC remains an important goal for many laboratories around the world. This study aimed at evaluating the diagnostic and prognostic value of serum IL-2R and Neutrophil Lymphocyte (N/L) ratio levels in patients with HCC. This study was conducted on forty two cases of HCC chosen from the Hepatology, Gastroenterology and Infectious diseases department, Benha University Hospital, as well as twenty eight patients with liver cirrhosis and another twenty apparently healthy subjects without evidence of chronic liver disease during the period from March 2012to December 2012. We found that HCC commonly presented in males with a male to female ratio 2.2:1 and the mean age was 56.9 years with a range between 42 and 80 years. Anti HCV Ab was found in 71.4% in HCC patients and also cirrhosis was found in 100% of HCC patients. Most of our HCC cases presented at Child B&C grade.
uMELD score was significantly higher in HCC cases, while no significant differences as regards MELD score. Ascites &PVT were predominant in HCC group, while shrunken liver was present more in cirrhosis group. Hepatic focal lesions tends to be single, oval, large , more frequent in Rt lobe and Neovascularization & halo sign were present in 90.5% of HCC cases. Most cases of HCC were stage III Okuda, were equally in early &advanced Tokyo stage, were CLIP stage II and according to VISUM stage most of HCC cases were stage I. Mean value of AFP in HCC cases was 504ng/ml which was statistically higher than that of patients with cirrhosis (247.6ng/ml) and control (2.2ng/ml) subjects. IL-2R was significantly high in HCC & cirrhosis than the control group but no significant difference between HCC and cirrhotic patients (P=0.293). For AFP as a diagnostic marker for HCC, the cutoff point that gives the optimum balance between sensitivity and specificity was 6ng/ml with AUC 81.3%, 71.4% sensitivity, 85.5% specificity. While for IL-2R the cutoff value was 13.3ng/ml with AUC 58.1%, sensitivity 69% and specificity 47.5%. N/L ratio had low sensitivity and low specificity and there was non-significant correlation between N/L ratio and AFP.
There was significant positive correlation between AFP, Okuda, CLIP and VISUM but there was non-significant correlation with the severity of the liver disease (Child, MILD and uMELD scores), N/L ratio, IL-2R and Tokyo stage. There was significant positive correlation between IL-2R and only MELD score and N/L ratio and also there was significant positive correlation between N/L and MELD, uMELD scores & IL-2R.