الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Worldwide, hepatocellular carcinoma (HCC) is the most common primary liver cancer with over one million new cases annually and the third leading cause of cancer related death. HCC is the major cause of death in patients with chronic hepatitis C virus (HCV) infection and responsible for approximately one million deaths each year
Egypt has the highest HCV prevalence worldwide where about 24% of the people are estimated to carry HCV and more than 50% of blood donors have anti-HCV in some towns .The burden of HCC has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. It contributes to 14.8% of all cancer mortality in Egypt.
Alpha Fetoprotein (AFP) is the most commonly used tumor biomarker currently available for the early detection and clinical follow up of patients with HCC its low sensitivity and specificity limits its value in diagnosis and recurrence of HCC, new serological markers with adequate affectability and specificity are expected to recognize HCC and its recurrence.
HCC is a highly vascular cancer, and it has been well established that angiogenesis plays an important role in its biological aggressiveness. HCC-derived angiogenic factors, such as vascular endothelial growth factor (VEGF) and fibroblast growth factor, are closely associated with tumor progression. The expression levels of these factors in tumors and sera have been shown to be predictive of recurrence and survival
Endocan, or endothelial-specific molecule-1, is a soluble proteoglycan of 50 kDa that is synthesized and secreted by activated vascular endothelial cells, including a tumor endothelial cells. Endocan production is upregulated by angiogenic factors and inflammatory cytokines, such as tumor necrosis factor and interleukin-lβ. In experimental studies, endocan has been found to induce tumor formation and to be closely associated with the conversion of dormant tumors into fast-growing angiogenic tumors.