الفهرس 
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Abstract
Hepatocellular carcinoma (HCC) constitutes around 90% of primary cancers of the liver.
Autophagy is important for cellular survival during states of starvation, stress, or infection. The mechanism is energy regeneration from intracellular substances to meet energy requirements in conditions of low nutrition.
Autophagy may function as a tumor inducer because the energy required by cancer cells (to sustain growth and survival under various metabolic as well as therapeutic stress conditions) was obtained from autophagy. Malignant progression and poor prognosis of HCC has been correlated with increased autophagy.
The only dual function molecule which acts as both a tumor suppressor and autophagy regulator is Beclin 1. Autophagy related protein-5 (ATG5) can control autophagy.
Decreased intracellular calcium levels lower Calpain 1 cleavage activity, up-regulate the level of ATG5 and ATG12-ATG5 and increase autophagy.
The aim of work is Studying the value of serum Beclin 1 and serum ATG5 among cirrhotic Hepatitis C Virus patients with and without hepatocellular carcinoma.
To study the relation between serum Beclin 1, serum ATG5 and biochemical parameters in cirrhotic Hepatitis C Virus patients with and without hepatocellular carcinoma. And serum Beclin 1 and ATG5 were estimated among HCC patients with and without metastasis.
This study was carried out on 80 subjects age range 18-60years.
group I: HCV patients subdivided into 3 subgroups: Thirty patients with cirrhosis, fifteen patients of cirrhotic HCV with HCC with metastases, fifteen patients of cirrhotic HCV with HCC without metastases.
group II: 20 healthy controls.
Inclusion criteria: Age range 18-60 years of both sexes.
Exclusion criteria: chronic HBV infection, any other cause of chronic hepatitis other than HCV, patients with suspected malignancies other than HCC, diabetes mellitus, chronic kidney disease, coronary disease and organ transplantation.
In This study, serum ATG 5 was lower in HCC patients than in patients with cirrhosis, but there was no statistically significant difference between patients with cirrhosis than control individuals. Also, ATG 5 was significantly lower in group of patients with metastasis than patients without metastasis
In this study, serum Beclin 1 was higher in HCC patients than cirrhotic patients but there was no was no difference between cirrhotic patients than control individuals. Also, serum BECLIN 1 was higher in group of patients with metastasis than patients without metastasis.
A simple score was suggested and formed of clinical and laboratory parameters (Cachexia, ATG 5 and Beclin 1) to estimate the future HCC risk in HCV related cirrhosis patients.
BCLC, ATG 5 and Beclin1 level were identified as being independently predicting metastasis of HCC. Prognostic fidelity was improved when combining these parameters in a scoring system with ATG 5, Beclin1 and BCLC score.