الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatitis B and C viruses represent the major reason of hepatocellular carcinoma in patients. The other risk factors are related to infection of food with toxic materials such as aflatoxin B1. In Egypt, HCV showed highest prevalence infection with majority of genotype 4 which is associated with HCC and cluster subtype 40. The current study was conducted on 50 patients classified into 3 groups. All clinicopathologic characteristics of patients were collected. group I: Patients with HCV-related HCC (n=30) who had focal hepatic lesion detected on ultrasonographic examination among patients with HCV-cirrhosis and were diagnosed as primary HCC according to their spiral CT findings and/or their histopathological examination. group II: Patients with hepatitis C cirrhosis (n=10) who were diagnosed by clinical, laboratory, ultrasonographic and histopathological evidence of liver cirrhosis (negative fibrosis). group III: Patients with hepatitis C fibrosis (n=10) who were diagnosed by clinical, laboratory, ultrasonographic and histopathological evidence of liver fibrosis. The mean age of the studied subjects is 59.7±7.6; range 44-77 years, the age of HCC group predominantly range 48 -70 years. Male gender predominates among HCV associated HCC group, they constitute 69% in comparison to 48% for females. Evaluating the serum AFP levels among the HCV associated HCC group; the current results showed that only 43% of patients showed high AFP levels which exceeds 500U/ml, otherwise; the majority 67% showed levels <500U/ml. Regarding the liver function tests; it was found that the majority of HCC associated HCV group had ALT and AST enzymes activity above 100U/ml, however; minor cases below this range. 53.3% of the HCC group had serum albumin levels ≤3.5 gm/dl. Levels of OPN gene expression and Pokémon gene expression were significantly higher in group I when compared to all HCV patients. group I also showed significantly higher serum levels of NO and MDA than when compared to all HCV patients. On the other hand, group I showed lower serum levels of caspase compared to group II and III. There was a significantly higher difference in group III (HCV-CLD / +ve fibrosis) than group II (HCV-CLD / -ve fibrosis) in levels of OPN and Pokémon gene expression. Group III also showed significantly higher serum levels of caspase and MDA than the other 2 groups. group III showed lower serum levels of NO. HCC patients showed a significantly higher gene expression of OPN in grade III when compared to grade I and II Also, OPN expression was higher in patients whose serum level of ALP exceeded 100 U/ml than in patients whose serum level of ALP <100 U/ml. Pokémon gene expression was significantly higher in grade III HCC patients compared to grade I and II. Also, Pokémon expression was higher in patients whose serum level of AFP exceeded 500 U/ml than patients whose serum level of AFP below 500 U/ml. In order to analyse the effect of HCV infection and fibrosis on the measured parameters; comparative analysis was conducted between HCV positive group (n=30) and a combination of group II and group III (n=20), moreover, between group II and III to evaluate the impact of fibrosis on the levels of the studied variables. High significant differences were observed for OPN and Pokémon genes expression, NO, MDA and caspase (p<0.01) between group I vs II and III and group II vs III. Higher levels were observed in HCV positive patients and hepatic fibrosis. OPN gene expression was significantly correlated to serum levels of AFP, caspase and NO in the HCV associated HCC group. Its expression levels also were correlated to levels of Pokémon gene expression. There was no correlation between expression of either OPN or Pokémon and the other measured parameters in HCV cirrhosis with fibrosis group. |