الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma is a significant cause of mortality worldwide and its incidence is increasing. HBV, HCV, schistosomiasis, alcoholism, and water pollutants are known to develop to HCC. Diagnosis of HCC can be difficult, and often requires serum markers, one or more imaging modalities, and histologic confirmation. HCC is diagnosed late. AFP is the most widely used serum biomarker for HCC and is elevated in up to 40% of patients with early-stage HCC, with expression increasing in advanced disease. Although AFP is not specific for HCC and may be seen in non malignant conditions such as chronic hepatitis, cirrhosis or fulminate hepatic failure, elevation of AFP and confirming ultrasound findings indicate malignant disease. Normal range for serum AFP levels is 5.2 ng /ml, and a level greater than 400ng/ml is regarded as positive. DCP has higher sensitivity and specificity than AFP in differentiating HCC from non malignant hepatopathy and detecting small HCC. Other markers, used alone or in combination with AFP have been evaluated for diagnosis or determining prognosis in HCC, as GEP, GGT, osteopontin, glypican-3, and glutamine synthetase. Markers as VEGF and IL, could be used as prognostic indicators, and simultaneous determination of AFP and these markers may detect the recurrence of HCC at its earlier period.