الفهرس 
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Abstract
Hepatocellular carcinoma(HCC)isahypervasculartumor characterized by
neovascularization. The objective of the current study was to determine circulating proangiogenic [vascular endothelial growth factor (VEGF), platelet derived growth factor (PDGF) and tumor necrosis factor (TNF-α)] and antiangiogenic [IL-4, IL-12, interferon gamma-induced protein 10 (IP-10), and angiostatin] factors in Egyptian patients with different stages of HCC. Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of these mediators in plasma of 135 HCC patients (57 Child- Pugh A, 24 Child-Pugh B, and 54 Child-Pugh C stage) and 50 healthy subjects. Results showed a significant increase in plasma levels of VEGF (P<0.001), PDGF (P<0.001), TNF- (P<0.01), angiostatin (P<0.01) and IP-10 (P<0.001) and a significant reduction in IL-12 (P<0.001) in HCC patients in relation to normal controls. Classifying HCC patients based on their Child-Pugh’s score revealed that the maximum production of proangiogenic mediators (VEGF and TNF-) was present in HCC patients with Child Pugh C score which coincides with maximum reduction in antiangiogenic mediators (IL- 4, IL-12 and angiostatin). Taken together, these results indicated that the determination of these factors in different Child-Pugh’s scores of HCC might be an important guide in clinical decision making regarding therapy and outcome.