الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer. Globally, liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death. Most of HCC burden lies in developing countries. The regions of high incidence include Eastern and South-Eastern Asia, Middle and Western Africa. The incidence of HCC increases progressively with advancing age in all populations, reaching a peak at 70 years. Males have a higher prevalence than females, the sex ratio usually ranging between 2:1 and 4:1 and in most areas
Around (80-90%) of HCC cases occur in the setting of underlying liver cirrhosis. Major causes for cirrhosis and hence HCC are various and include viral hepatitis C, B (HCV, HBV), aflatoxin, alcohol and smoking. In Egypt, HCV is the main risk factor for HCC. The Egypt Demographic and Health Surveys (EDHS) measured antibody prevalence among the adult population aged 15-59 years at 10.0% in 2015.
Patients with cirrhosis are at greatest risk for development of HCC and should undergo semi-annual surveillance using ultrasound with or without alpha fetoprotein. Patients with positive surveillance testing should undergo contrast-enhanced MRI or triphasic CT for diagnostic evaluation. There are therapeutic options for most patients with any tumor stage; however, treatment decisions must be in line with degree of liver dysfunction and patient performance status.
The aim of our study is to investigate the presence of GP73 in serum of patients with HCC and determine its efficacy as screening test for early detection of HCC.
This study included (75) subjects from inpatients wards and outpatients clinics of the Oncology and Internal medicine department at Menoufia Liver Institute during the period from June 2018 till December 2018. Subjects were classified into three groups: group I: patients already diagnosed as HCV related liver cirrhosis with HCC (30 patients). Patients were diagnosed as having HCC by radiological features of HCC by ultrasound and confirmed by triphasic abdominal CT. group II: patients with HCV related liver cirrhosis (30 patients). group III: healthy control group (15 subjects).
Inclusion criteria:
Patients with HCV related HCC.
Patients with HCV related liver cirrhosis.
Exclusion criteria:
HCC patients with distant metastasis.
Patients with malignancies other than HCC.
SUMMARY
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All the patients will be subjected to:-
Thorough medical history taking.
Complete physical examination with particular emphasis on signs of chronic liver disease.
Laboratory investigations:
1. Complete blood count.
2. Blood urea and serum creatinine.
3. Liver function tests :-
ALT, AST.
Serum bilirubin (Total & Direct).
Prothrombin time and concentration.
Serum albumin.
4. Alpha fetoprotein
5. Serological markers:-
HBsAg
HCV Ab
Imaging techniques:
abdominal ultrasound
abdominal triphasic C.T scan
Specific investigations:
All three groups will undergo ELISA test to detect GP73 in their serum.
Results showed that:
No significant difference between HCC group and Cirrhotic group regarding age.
Hepatocellular carcinoma (HCC) is highly prevalent in males.
No significant difference between HCC group and Cirrhotic group regarding liver clinical manifestations.
No significant difference between 3 groups regarding WBCs count, but regarding Platlets count, there was highly significant difference between HCC group and Control group and between Cirrhotic group and Control group being lower Platlets count in HCC and Cirrhotic groups and regarding hemoglobin concentration showed significant difference between HCC and Cirrhotic group and highly significant difference between Cirrhotic group and Control group being lower HB concentration in Cirrhotic group.
The mean AST and ALT values were highly significant higher in HCC group and Cirrhotic group than in Control group with no significant difference between HCC group and Cirrhotic group.
SUMMARY
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There was highly significant difference regarding mean values of serum albumin, total, direct bilirubin and INR between HCC group and Control group and between Cirrhotic group and Control group being lower albumin, higher total, direct bilirubin and INR in HCC and Cirrhotic groups, Although showed significant difference regarding serum albumin and INR between HCC and Cirrhotic groups being lower albumin and higher INR in Cirrhotic group with no significant difference regarding total and direct bilirubin.
The mean AFP level in HCC group was significant higher than Cirrhotic group, while the mean AFP levels in HCC and Cirrhotic groups were highly significant higher than Control group.
The mean GP73 level in HCC group was highly significant higher than Cirrhotic and Control groups and the mean GP73 level in Cirrhotic group was highly significant higher than Control group.