الفهرس 
Liver CirrhosisOnly 14 pages are availabe for public view
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Abstract
Inflammation has been identified as the major mechanism that promotes progression of chronic liver diseases, leading to hepatic fibrosis and cirrhosis.
At present, liver biopsy is the gold standard to assess the degree of intrahepatic inflammation. In clinical routine, non-invasive, longitudinally measurable biomarkers for local and systemic inflammation would be highly desirable, as they may allow early identification of patients at risk for cirrhosis or at risk for fatal outcome.
The urokinase plasminogen activator receptor (uPAR) is expressed on most leucocytes including neutrophils, lymphocytes, monocytes and macrophages, which are crucially involved in the pathogenesis of hepatic inflammation and fibrosis.
In addition to the membrane anchored form, uPAR can be found as a soluble molecule in the serum termed Soluble urokinase plasminogen activator receptor (suPAR).
The aim of this study is to assess the significance of soluble urokinase plasminogen activator receptor (suPAR) in different grades of liver cirrhosis.
This study was conducted on 50 patients attending at the Gastroenterology and Hepatology Unit of the Internal Medicine Department at Ain Shams University Hospital from August to December 2012. After evaluation of each patient and applying exclusion criteria, they were divided into 30 patients with liver cirrhosis in different stages (Group I) and 20 patients with non-cirrhotic chronic viral hepatitis considered as the control group (Group II).
All patients were subjected to full history, thorough clinical examination and laboratory analysis as complete blood picture, liver function tests, and kidney function tests. They were also subjected to abdominal ultrasonography and estimation of serum Level of suPAR.
Serum levels of suPAR were found to be much higher in cirrhotic group I (5911.33±1317.40 ng/l) than in the control non-cirrhotic group II (2973.00±282.32 ng/l). our study also showed a highly significant direct correlation between serum levels of suPAR and the severity of liver cirrhosis as shown by Child-Pugh scoring system. We also found a highly significant direct correlation between serum levels of suPAR and MELD score which is currently the best validated prognostic multifactorial tool in advanced liver diseases.
We found a highly significant direct correlation between serum levels of suPAR and each of total bilirubin and INR, a highly significant inverse correlation between serum levels of suPAR and serum albumin in cirrhotic patients.
But a nonsignificant correlation was found between serum levels of suPAR and each of serum liver enzymes (ALT and AST), serum creatinine, hemoglobin level, WBCs and platelet count in cirrhotic patients.
The study concluded that suPAR could be used as a non-invasive serum marker for the diagnosis of liver cirrhosis and also it has been shown to be of prognostic value as cirrhotic patients displayed significantly higher suPAR levels as compared with non-cirrhotics and there was a strong association between elevated serum levels of suPAR and the severity of liver cirrhosis as shown by Child-Pugh scoring system as well as a highly significant direct correlation with the MELD score, total bilirubin level and INR and a highly significant inverse correlation with serum albumin in cirrhotic patients.