الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
HCC is a major health problem with very high mortality and many related risk factors especially HCV which is highly prevalent in Egypt. Biological behavior of HCC is a challenging issue and many studies are still trying to solve this mystery. The tissue microarray (TMA) is a novel rapid technique allowing multiple tissues to be mounted on a single slide and each tissue sample can be handled in an equal manner using very small amount of reagent. This study aimed to evaluate diagnostic and prognostic value of Tissue expression of both S100A4 protein and GPC3 in HCC in Egyptian cirrhotic patients after hepatectomy and local ablation. The study included 83 patients with HCC. 1st group included 70 patients who have been planned for hepatectomy. Tissue of the hepatectomy group was prepared for constructing tissue microarray. The 2nd group included 13 patients who have been planned for local ablation and tissue was obtained by trucut biopsies. Tissue of the trucut group was prepared on conventional slides. Control group was obtained from tumor-adjacent tissue. Tissue of both groups was immunohistochemically stained by mouse monoclonal antibodies against SA100A4 and Glypican3. Patients were followed up for up to 40 months for detection of local recurrence, metastasis and/or decompansation. Results: GPC3 was more expressed in HCC than S100A4. S100A4 was more significantly expressed in cases showing metastasis, microscopic vascular emboli, necrosis and grade III tumors while no significant association with GPC3 expression with all these parameters. GPC3 expression was associated with time of HCC recurrence while not with S100A4. The median level of AFP was higher in both positive cases for S100A4 and GPC3. There was no relation between overall survival and both S100A4 and GPC3. The median overall survival was shorter in decompensated patients and in higher grade tumors. After univariate regression analysis, the only independent predictor for recurrence which was significant is decompansation. After univariate regression analysis, the following independent predictors for metastasis were significant: S100A4 positive staining and necrosis. After multivariate regression analysis, the most significant predictor was S100A4 positive staining. Conclusion: S100 calcium binding protein A4 (S100A4) could be a marker for hepatocellular carcinoma (HCC) progression that is related to tumor metastasis, grading and microscopic vascular invasion. Glypican 3 is a reliable marker of HCC diagnosis but its prognostic value needs further research.