الفهرس 
chapter 1Only 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma is one of the most common cancers worldwide it accounts for 85-90% of all primary liver cancers, with a median survival of less than one year, its very poor prognosis makes it the third leading cause of cancer- related death responsible for approximately 600,000 deaths annually, it is a serious health problem, with more than 500,000 cases are diagnosed every year all over the word
In Egypt, HCC was reported to account for about 4.7% of chronic liver disease patients, with a doubling in the incidence rate in the past 10 years, the epidemic of HCC in Egypt is associated with hepatitis C viral infection (HCV) where Egypt has the highest prevalence of hcv in the world with about 13.8 % of the population infected and seven million person with chronic hcv liver disease.
Early diagnosis remains the key to effective therapy of hcv, also early detection of hcc cells spreading into the circulation and for metastic recurrence is important for the early prediction of the relapse and prognosis of the hcc patients however it is difficult to detect such spreading cells of hcc through the blood route with conventional technique .
This study was conducted on ninety individuals and classified into three groups as follows; group I (hcc group) that includes 40 hcc patients who further classified pathologically to stage 1 (9) patients and stage II (31) patients , group II (cirrhotic group ) that includes 30 patients with liver cirrhosis (lc); and group III (healty control) which includes 20 volunteering apparently normal healty individuals as controls, the following measures wrere carried out , routine laboratory investigations including ( Hb, platelets, WBCs, RBC, S ) using Beckman cx9 autoanalyser (Beckman Inst, Total bilirubin ) were performed using Bekman CX9 autoanalyser , Prothrombin time & concentration and INR were done using axsym instrumental that based on the microparticle enzyme immunoassay (MEIA) technology, serum DKKI and serum midkine were done using ELISA kit , and abdominal ultrasound . only those in HCC group underwent further imaging in the from of abdominal triphasic spiral CT magnetic resonance imaging as apart of HCC diagnosis.