الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer (Cai et al., 2015). HCC is the fifth most common cancer and the third most common cause of cancer-related death globally (Elsayed et al., 2015). There is wide geographic and age-related variation in its incidence, which is largely related to the prevalence of the hepatitis B and C viruses. These viruses are strong risk factors for developing HCC (Cai et al., 2015).In Egypt, hepatocellular carcinoma is the second most common cancer in men and the 6th most common cancers in women. Hospital-based studies from Egypt have reported an overall increase in the relative frequency of all liver-related cancers in Egypt, from approximately 4% in 1993 to 7.3% in 2003 (El-Zayadi et al., 2005). The burden of hepatocellular carcinoma has been increasing in Egypt with a doubling in the incidence rate in the past 10 years (Vxi et al., 2013). It contributes to 14.8% of all cancer mortality in Egypt (Aleem et al., 2012). Egypt has possibly the highest hepatitis C virus (HCV) prevalence worldwide (Omar et al., 2013). Approximately 14% of the population in Egypt is infected with HCV and 7 million people are believed to suffer from a chronic liver disease (Goldman et al., 2009). Also, up to 90% of HCC cases were attributed to HCV infection (Ezzat et al., 2005). Cirrhosis secondary to HCV is associated with the highest annual risk for developing HCC (El-Serag, 2012). Without effective intervention, the number of patients with HCV-related cirrhosis or HCC is estimated to double by 2020 (Davis et al., 2010). HCC is the most common primary liver cancer and its burden has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. Up to 90% of HCC cases were attributed to HCV related cirrhosis. A multidisciplinary approach includes clinical, radiological, and laboratory modalities with or without liver biopsy is required to establish the diagnosis of HCC. Most of the patients are diagnosed in a late stage, and despite the multiple management modalities, the general prognosis is still poor. Therefor there is a necessity for developing non-invasive surveillance tools and confirmative biomarkers for the early detection of HCC. AFP which is the most widely used and broadly known biomarker for HCC, unfortunately can be elevated in patients with chronic hepatitis and/or cirrhosis in the absence of HCC, leading to an unreliable role of serum AFP alone in HCC surveillance. Galectin 3, a pluripotent growth factor, was suggested to be increased in serum, and tissues of patients with HCC. This study aimed at validating the diagnostic ability of serum Galectin 3 versus serum AFP in early detection of HCC.A single center, observational, prospective study was conducted on HCV cirrhotic patients and HCC on top of related cirrhosis selected from attendees of the outpatient clinics or those admitted at Gastroenterology and Hepatology Unit, Specialized Medical Hospitals, Mansoura University. They were compared to age and sex matched cirrhotic patients without HCC . HCC has been found to be more prevalent in males specially in older patients .This study showed that the accuracy of galectin 3 in diagnosing HCC at cutoff value of ≥ 9.85 is not statistically significant with a sensitivity of 84% and a specificity of only 44% . AFP is capable of diagnosing HCC at cutoff value of ≥ 45.35 with a sensitivity of 77% and specificity of 80%. Comparison between the AUC of the two markers showed a statistically significant difference with AFP being a better marker than Galectin 3.There was no correlation between serum galectin 3 levels and serum AFP levels or to the focal lesion size . Serum galectin-3 levels is not a reliable marker for diagnosis of HCC in top of HCV related cirrhosis while AFP is more specific marker for diagnosis of HCC in top of HCV related cirrhosis