الفهرس 
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Abstract
The aim of the thesis is to study the role of thioredoxin analysis in the early diagnosis of HCC patients with viral cirrhosis. Data were collected from 90 patients divided, into 30patients diagnosed HCC with lowAFP,30Patients liver cirrhosis into child A, B,C ,10 patients HCC with High AFP , 10 patients chronic liver disease on Hemodialysis machine ,and 10 Healthy peoples , and the level of thioredoxin in the blood was assessed using ELISA technique. The level of thioredoxin in patients with malignant hepatocellular carcinoma was shown to be significantly higher compared to patients not diagnosed with malignant hepatocellular carcinoma. Thus, thioredoxin analysis can be used as a useful diagnostic tool in the early detection of malignant liver cancer in patients with viral cirrhosis.
Early detection of HCC can lead to better treatment outcomes, but current diagnostic methods are not always reliable. Recent studies have shown that serum thioredoxin (TRX) may be a potential prognostic marker for HCC. TRX is an antioxidant enzyme that is upregulated in various types of cancer, including liver cancer. Elevated serum TRX levels have been found in HCC patients compared to healthy controls, and it can differentiate between HCC and other liver diseases such as cirrhosis and hepatitis.
Measurement of serum TRX may be particularly useful for the early diagnosis of HCC in patients with cirrhotic hepatitis. Studies have demonstrated that increased serum levels of TRX can be detected in those patients who develop HCC, even before any clinical symptoms appear. This indicates that measurement of serum TRX levels can help identify patients at risk of developing HCC, allowing for early intervention.
However, the use of serum TRX as a prognostic marker for HCC has some limitations, including the potential effect of inflammation and oxidative stress on TRX levels. More research is needed to determine optimal cut-off values for TRX in the diagnosis of HCC. However, the potential of serum TRX as a prognostic marker for HCC is an exciting area of research that could improve early detection and treatment of this deadly cancer.
Conclusion:
Thioredoxin can be used as marker in early detection of HCC especially in patients with low or negative AFP otherwise the combined AFP, Thioredoxin give more sensitivity and specificity more than alone .