الفهرس 
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Abstract
13C- aminopyrine breath test (13C-ABT) is a simple, sensitive tool to evaluate liver function, and its results may discriminate between patients with or without cirrhosis (Mion et al. 1995). Also, It was previously reported that, in patients suffering from chronic liver disease of various aetiologies, 13C-ABT can discriminate between those with chronic hepatitis and those with cirrhosis (Fasoli et al., 2000). It was reported that breath test can be used as a prognostic index in liver metastases even if concurrent biochemical liver tests are normal or only slightly disturbed (Blairvacq et al., 1993). The aim of this study was to compare 13C-ABT results between normal subjects, patients with liver cirrhosis and those with hepatoceullar carcinoma in order to identify function differences between various chronic liver diseases and to evaluate different methods of expressing 13C-ABT results and to maximize the information obtained from the test. This study was carried out on 60 patients and 15 normal subjected divided into three groups: Group I: Thirty patients with liver cirrhosis. Group II: Thirty patients with hepatocellular carcinoma. Group III: Fifteen healthy volunteers of matched age and sex to patient groups as a control group. All had normal liver ultrasound results and routine liver function tests and none had a history of previous or active liver disease. The results of this study showed that: - There was no significant difference between the three groups as regards age and sex.
- As regards Child classification, the percentage of class C patients was significantly higher in HCC group while the percentage of class A patients was significantly higher in cirrhosis group. Child score was significantly higher in HCC group compared to cirrhosis group. - The mean serum bilirubin level was significantly higher in HCC group compared to cirrhosis group and control group, while no significant difference between cirrhosis group and control group. - The mean values of serum AST and ALT were significantly higher in HCC group compared to cirrhosis group and control group, while there was no significant difference between cirrhosis group and control group. - The mean values of serum GGT were significantly higher in cirrhosis group and HCC group compared to control group, while no significant difference between cirrhosis group and HCC group. - The mean values of serum alkaline phosphatase were significantly higher in cirrhosis group and HCC group compared to control group, it was also significantly higher in HCC group compared to cirrhosis group. - The mean serum albumin concentration was significantly lower in HCC group compared to control group, while there was no significant difference between cirrhosis group and the other two groups. - Prothrombin activity was significantly lower in cirrhosis group and HCC group compared to control group, while there was no significant difference between cirrhosis group and HCC group. - AFP was significantly higher in HCC group compared to the other two groups, while no significant difference between cirrhosis group and control group.
- The mean aminopyrine % dose/hour after 60 minutes was significantly lower in cirrhosis group and HCC group compared to control group, and it was significantly lower in HCC group compared to cirrhosis group. - The mean aminopyrine % cumulative dose after 120 minutes was significantly lower in cirrhosis group and HCC group compared to control group, and it was significantly lower in HCC group compared to cirrhosis group. - There was no significant difference between both groups as regards cause of cirrhosis. - In cirrhosis group, there was no significant difference as regards mean aminopyrine measurements between hepatitis C patients and hepatitis B patients. - In cirrhosis group, the mean aminopyrine % dose/hour and the mean aminopyrine % dose/hour were significantly higher in Child class A patients compared to Child class B patients and Child class C patients. Also, it was significantly higher in Child class B patients compared to Child class C patients. - The mean aminopyrine % dose/hour and the mean aminopyrine % cumulative dose were significantly higher in Child class B and Child class C patients in cirrhosis group compared to HCC group. - In cirrhosis group, there was significant inverse correlation between aminopyrine % dose/hour and Child score, while there was significant direct correlation with serum albumin. Also, there was significant inverse correlation between aminopyrine % cumulative dose and Child score, while there was significant direct correlation with serum albumin.
- In HCC group, there was significant inverse correlation between aminopyrine % dose/hour and Child score. Also, there was significant inverse correlation between aminopyrine % cumulative dose and Child score. There was significant inverse correlation between aminopyrine % dose/hour and tumour size. Also, there was significant inverse correlation between aminopyrine % cumulative dose and tumour size. - In HCC group, there was significant direct correlation between AFP and tumour size. - The sensitivity of AFP in diagnosis of HCC was 86.7%, the specificity was 100% and the accuracy was 93.3% at cut off value of 400. - The sensitivity of ABT in diagnosis of HCC (Child B) was 90.9%, the specificity was 100% and the accuracy was 95.8% at cut off value of 1.6. The sensitivity of ABT in diagnosis of HCC (Child C) was 94.7%, the specificity was 100% and the accuracy was 96.6% at cut off value of 1.2.