الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is the fifth most prevalent malignant tumour and the third leading cause of cancer related death worldwide, accounting for over half a million deaths per year. chronic hepatitis C (HCV) viral infection play a major role in the HCC etiology.
In Egypt, the incidence rate of HCC has increased sharply in the last few years. This could be due to HBV and HCV endemic infection.
Single nucleotide polymorphism (SNP) is a variation of the DNA sequence in which a single nucleotide of the sequence has been altered.
These highly abundant SNPs occur in every 1000 bases in the human genome.
Reversion-inducing-cysteine-rich protein with kazal motifs, also known as RECK, is a membrane-anchored glycoprotein thought to be a tumor suppressor gene. The RECK gene is widely expressed in numerous normal tissues and non-neoplastic tissues .The human RECK gene spans across a 87 kb region and contains 21 exons and 20 introns, with 13 single nucleotide polymorphisms (SNPs).Four SNPs were identified in the coding region of the gene (exons 1, 9, 13 and 15), and the remaining nine in introns 5,8, 10, 12, 15 and 17. Among these 13 SNPs, rs11788747 was found within the coding sequence in exons 13.
This study aimed to verify whether the rs11788747A/G single nucleotide polymorphism of RECK was associated with developing Hepatocellular Carcinoma (HCC) among chronic hepatitis C virus (HCV) infected Egyptian patients.
This study included 100 subjects. The studied subjects were divided into three groups, group 1 (control group) included 30 apparently healthy age and gender matched subjects (18 males and 12females), their age ranged between 43-63 years, group 2 (cirrhosis group) included 35 diagnosed patients with cirrhosis and positive anti HCV antibodies (22 males, 13 females), their age ranged between 42-62 years, and group 3 (HCC group) included 35 diagnosed HCC patients (21 males, 14 females), their age ranged between 44-68 years.
All studied individuals were subjected to the following:
Full history taking, complete clinical examination, abdominal US and or CT for patient groups and laboratory investigation including:
Liver function tests including(total and direct bilirubin, AST, ALT, GGT, ALP, total protein and albumin),HCV antibodies, serum AFP and genotyping of RECK rs11788747 A/G polymorphism by PCR-RFLP.
The results of this study can be summarized as follow:
All the studied groups were homogenous regarding age and gender, as there is no statistically significant difference among the three studied groups.
Statistically significant difference was found between control group, cirrhotic patients on top of HCV group and HCC group regarding all studied parameters with a significant increase in total and direct bilirubin,AST, ALT, ALP, GGT, Total bilirubin,PT,PC, INR and AFP in HCC group compared with cirrhotic patients on top of HCV group and control group . Whereas, there was a significant decrease in albumin and total protein in HCC group compared with cirrhotic patients on top of HCV group and control group.
No statistically significant difference in RECK(rs11788747) Genotype distribution between control and cirrhotic patients on top of HCV groups. However, there was significant difference in RECK(rs11788747) Genotype distribution between control and HCC groups. and there was a significant differences in RECK(rs11788747) Genotype distribution between cirrhotic patients on top of HCV group and HCC group.
Mutant (AG) genotype was significantly higher in HCC group than control group, also mutant (GG) genotype was significantly higher in HCC group than control group.
Mutant (AG) genotype and also mutant (GG) genotype were significantly higher in HCC group than cirrhotic patients on top of HCV group.
Statistically significant difference in normal allele (A) and mutant allele (G) distribution between control and HCC group .Mutant (G) allele was statistically higher in HCC group than control group.
Statistically significant difference in normal allele (A) and mutant allele (G) distribution between cirrhotic patients on top of HCV group and HCC group .Mutant (G) allele was statistically higher in HCC group than cirrhotic patients on top of HCV group.
LN metastasis and tumor distant metastasis in HCC group was statistically significant higher in (AG/GG) genotype than (AA) genotype.
No statistically significant difference was found between the gene polymorphism and laboratory findings (AST, ALT, GGT, ALP, Albumin, total protein, total bilirubin, direct bilirubin, PC, PT, INR and AFP) in HCC group , cirrhotic patients on top of HCV group and control group .