Abstract
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related mortality worldwide. In an attempt to understand some potential mechanisms of persistence and oncogenicity of Hepatitis C virus (HCV)-related HCC, microfibrillar-associated protein 4 (MFAP4), fibrotic indices and oxidative status biomarkers were assessed in the sera of 50 patients with HCV-associated HCC, 25 patients with HCV-related liver cirrhosis and 15 healthy individuals. Serum oxidized Coenzyme Q10 (CoQ10) and malondialdehyde showed significant elevation in HCC patients compared to the control group (p < 0.001), as well as cirrhotic patients (p < 0.05 and p < 0.001, respectively), while serum glutathione content and superoxide dismutase activity were significantly decreased in HCC patients compared to the control group (p < 0.001). Serum MFAP4, aspartate aminotransferase to platelet ratio index (APRI), fibrosis index based on the 4 factors (FIB-4) and Forns index showed significant increase in HCC patients compared to the control group (p < 0.001), while only APRI and FIB-4 were significantly different between HCC and cirrhotic patients (p < 0.05), with a sensitivity of 86% and 92%, respectively, at cut off ≥0.7 for APRI and ≥1.57 for FIB-4. Therefore, increasing oxidative stress and fibrosis might mediate HCV induced cirrhosis and HCC. APRI and FIB-4 may be used as a simple non-expensive formula for the screening of HCC rather than MFAP4.
Highlights
Hepatocellular carcinoma (HCC) is a sophisticated health challenge; it represents the second leading cause of cancer-related mortality worldwide [1]
All of them developed HCC associated with cirrhosis related to chronic hepatitis C infection and were seronegative to HBsAg and HIV antibodies
All were seronegative for Hepatitis C virus (HCV), HBsAg and HIV antibodies with normal laboratory and radiological findings
Summary
Hepatocellular carcinoma (HCC) is a sophisticated health challenge; it represents the second leading cause of cancer-related mortality worldwide [1]. Cancer Registry ranks liver cancer as first cancer among males and the second among females after breast cancer [2]. Hepatitis C virus (HCV) attributes to about 90% of the HCC patients in the Egyptian population [3], where Egypt has the highest prevalence of HCV infection in the world (15%) and the main HCV genotype (90%) is type 4 [4]. Hepatic carcinogenesis is a slowly progressive, poorly understood multistep process [5]. Alteration in hepatic microenvironment mediates the carcinogenesis and carries the clues for better.
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