الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancers, and about 10.9 million new cases diagnosed annually. HCC represents the sixth most common cancer worldwide and it is the third leading cause of cancer-related deaths globally.
Multiple etiological risk factors lead to HCC such as chronic HCV infection, chronic HBV infection, NAFLD, aflatoxin, alcohol, hemochromatosis, alpha-1-antitrypsin deficiency and wilson’s disease. This risk factors promote formation of cirrhosis, which is the main risk factor for HCC. chronic HCV is a major risk factor for the development of HCC in Egypt which has the highest HCV prevalence in the world.
The clinical picture of HCC is extremely variable; at early stages patients are usually asymptomatic except for symptoms related to their chronic liver disease. HCC should be highly suspected in patients presenting with acute decompensation of previously compensated liver cirrhosis, with accelerated liver function deterioration as jaundice, ascites, peripheral oedema, hepatic encephalopathy and bleeding.
Practice guidelines have recommended HCC surveillance for cirrhotic patients at high risk, By ultrasound abdomen to detect focal hepatic lesion together with serum AFP measurement. Serum AFP has been used extensively as a biomarker for HCC, but its performance in HCC surveillance has been generally low.
A recent study found a sizeable improvement in the AFP-based risk assessment by adding several laboratory parameters to the predictive model which discriminates between cirrhotic patients who did and did not develop HCC.
The present study aimed to assess the efficacy and accuracy of different studied laboratory parameters in diagnosis of HCC in HCV-related cirrhotic patients.
This study was conducted on 400 patients who were admitted to Hepatobiliary Unit, Internal Medicine Department, Alexandria Main University Hospital. They were divided into two groups.
group I: 200 patients with HCV related liver cirrhosis.
group II: 200 patients with HCC on top of HCV related liver