Abstract
Background and study aim : Many studies have reported that insulin resistance raises the risk of primary hepatocellular carcinoma (HCC). Caspase-generated cytokeratin-18 (CK-18) fragments are produced during apoptosis of hepatic cells. The present study aims to evaluate the value of serum CK-18 and the impact of insulin resistance on recurrence of HCV related HCC in patients treated with radiofrequency ablation (RFA). . Patients and Methods: The present study was conducted on 60 HCV patients. Group I: 30 patients with HCC treated by RFA and group II: 30 non HCC cirrhotic patients. Insulin resistance was estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) and CK-18 level was measured for all patients using ELISA. Results: HOMA-IR and CK-18 levels were significantly elevated in HCC patients when compared to non HCC cirrhotic patients. There was a significant increase in CK-18 and HOMA-IR levels in patients with local recurrence versus those with no recurrence (p<0.001). Univariate analysis revealed that HOMA-IR (p=<0.001) and CK-18 (p=<0.001) were significant predictors of recurrence of HCC. Conclusion: CK-18 and HOMA-IR are potential prognostic markers as they can predict the recurrence of HCC.
Highlights
Hepatoceullar carcinoma (HCC) is a common cause of cancer-related death and its incidence is increasing worldwide [1]
Steatohepatitis is associated with Insulin resistance (IR) and characterized by inflammation, apoptosis of liver cells, fat and fibrotic tissue accumulation in the liver, which may progress to cirrhosis and HCC
This study was conducted on 30 hepatitis C virus (HCV) related HCC patients and 30 HCV related cirrhotic patients
Summary
Hepatoceullar carcinoma (HCC) is a common cause of cancer-related death and its incidence is increasing worldwide [1]. The currently increasing incidence of HCC in Egyptians may be due to the increased prevalence of hepatitis C virus (HCV) as a primary risk factor [2]. Diabetes mellitus (DM) increased the risk of chronic non-alcoholic liver disease and HCC in male patients without concomitant liver disease [3]. Steatohepatitis is associated with IR and characterized by inflammation, apoptosis of liver cells, fat and fibrotic tissue accumulation in the liver, which may progress to cirrhosis and HCC. Many studies have reported that insulin resistance raises the risk of primary hepatocellular carcinoma (HCC). The present study aims to evaluate the value of serum CK-18 and the impact of insulin resistance on recurrence of HCV related HCC in patients treated with radiofrequency ablation (RFA)
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