الفهرس 
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Abstract
Background: Hepatocellular carcinoma (HCC) is now regarded as one of the major malignant disease worldwide, with significant variations in its epidemiology. Objective :Study of the epidemiology of hepatocellular carcinoma and its relation to age, sex, residence, viral hepatitis B&C in Egypt. From 1994 to 2005, 1042 cases with hepatocellular carcinoma diagnosed in Gastroenterology center, Mansoura University, Egypt. All patients evaluated for age, sex, residence, occupation, history of other medical disease, anti-bilharzial treatment, blood transfusion, viral markers, liver functions, tumor size-site, multiplicity, vascular invasion and manage Results:The mean age was 54.26 ±9.2, with high prevalence between 51 and 60 years. Males to female’s ratio 5:1and presented 3 years earlier in females. Farmers constitute 37.6 %, workers 22.9% and housewife 12.8% of patients. The number of HCC patients increasing yearly as only 9 patients evaluated at 1992 to 80 patients in the first 5 months of the year 2005. The mean age is increasing from 45 years at 1994up to 58 years at year 1996. 77% of patients are resident in rural versus 23% in urban. The male in rural area represents 84.9% versus 80.7% in urban. Seventy-eight patients presented by abdominal pain, 7.1% with abdominal swelling, 4.3% with jaundice, 2.4% with other symptoms and 8.8% discovered accidentally. Clinical and laboratory study revealed that, 52.1% of patients are Child’s A, 37.3% B and 10.7% C. Radiologically, 65.5% of patients had tumor size >5cm, the right lobe was the site of HCC in 63.9%, left lobe in 25.8% and both lobe in 10.3% of patients. Lesions were single in 71.1%, multiple in 24.9% and diffuse in 4% of cases. Portal vein thrombosis was detected in15.9%. history of anti bilharzial treatment was positive in 37.6%. Hepatitis C, B and mixed B&C was76.6%, 3.3%, 3.6% respectively. History of blood transfusion was encountered in only 10.6%. Twenty seven percent of HCC patients had previous history of surgical interference.Conclusion: The newly diagnosed patients with hepatocellular carcinoma are is increasing annually. The prevalence of HCC is high in the North Nile Delta area, more common in male, rural residents and farmers especially in HCV patients. In rural area there are others risky factors that may be responsible for this high incidence and need more study as pollution, aflatoxins and use of insecticides.