الفهرس 
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Abstract
HCC represents an international public health concern as one of the
most common and deadly cancers worldwide. It is the third most common
cause of cancer-related death worldwide. In Egypt, HCC is the second
most common cancer in men and the 6th most common cancers in
women.
In most cases, HCC develops within an established background of
chronic liver disease (70–90% of all patients). The worldwide
heterogeneous incidence reflects variations in the main risk factors which
include cirrhosis, viral hepatitis (HBV and HCV), aflatoxin, exposure to
pesticide and genetic host factors.
Genetic host factors play an important role in HCC development.
The most common form of genetic variation between individuals is SNP
which correspond to a modification of a DNA sequence due to the change
of a single nucleotide. SNPs in the methylene tetrahydrofolate reductase
(MTHFR) gene and epidermal growth factor (EGF) gene polymorphism
seem to be associated with HCC development.
Specific recognition of cis-regulatory regions is essential for
correct gene regulation in response to developmental and environmental
signals. Such DNA sequences are recognized by transcription factors that
recruit the transcriptional machinery.
1,25(OH)2vitamin D initiates biological responses via binding to
VDR which modulates the transcription of genes encoding proteins that
regulate the traditional genomic functions of vitamin D, including
signaling intestinal calcium and phosphate absorption.
1,25(OH)2D3/VDR control of gene expression also delays chronic
diseases of aging such as osteoporosis, cancer, diabetes, vascular disease,
and infection.
VDR likely reduces risk for many cancers by inducing the p53 and
p21 tumor suppressors, as well as DNA mismatch repair enzymes.
This study was conducted on 40 patients with HCC in addition to
40 patients with liver cirrhosis but with no radiological evidence of HCC
presented to Hepatology Department, National Liver Institute, Menoufiya
University in the duration between February 2015 and February 2016.
Twenty age and gender matched healthy subjects served as a control
group.
The present study showed a highly significant statistical difference
in Apa-I Vitamin D receptor (CC) genotype with increased (C) allele
frequency in HCC patients than both cirrhotic and control groups.
The study of the correlation between Apa-I genotype and
laboratory characteristics in HCC group showed significantly lower
albumin levels with C/C genotype compared with other genotypes. In
addition, patients with C/C genotype had significantly higher AFP level
and larger tumour size when compared to other genotypes. Also, there
was no statistical difference between Apa-I genotype and Child Pugh
grades, INR, liver enzymes, total bilirubin, direct bilirubin, total calcium
and phosphorus.