الفهرس 
HEPATOCELLULAR CARCINOMAOnly 14 pages are availabe for public view
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Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common and aggressive malignancies worldwide. The non-classical actions of vitamin D, namely anti-proliferation, pro-differentiation, pro-apoptosis, anti-inflammation, antiangiogenesis and immune regulation, have received great attention during the past decade. However, the association between vitamin D status and hepatitis C virus (HCV)- related HCC has not been fully investigated. This study aims to investigate the association of vitamin D receptor gene polymorphism with the development of HCC in Egyptian patients with hepatitis C virus (HCV)-related liver cirrhosis.Methods: This study included 60 subjects; 20 healthy volunteers as a control group, 20 patients with HCV-related liver cirrhosis and 20 patients with HCC on top of HCVrelated liver cirrhosis. Serum 25-hydroxyvitamin D level was measured and vitamin D receptor gene polymorphism was determined.Results: Serum 25-hydroxyvitamin D levels were significantly lower in patients with HCC than in those with liver cirrhosis (P=0.029) and controls (P=0.001). Among HCC patients, there was significant decrease in serum 25-hydroxyvitamin D levels with advanced Child-Pugh class. There were no significant correlations between serum 25-hydroxyvitamin D levels and both tumor size or BCLC stage. Using ROC curve analysis, serum 25-hydroxyvitamin D had 75% sensitivity and 65 % specificity for HCC, at a cut-off value of 10.5 ng/ml. Positive and negative predictive values for 25-hydroxyvitamin D were 68 and 72%, respectively. Regarding vitamin D receptor Apa I genotypes, AA, AC and CC genotypes were found in all studied groups. CC genotype was associated with the risk of HCC. In addition, vitamin D receptor Fok I genotypes,FF, Ff and ff genotypes were found in all studied groups. ff genotype was associated with the risk of HCC Conclusions: Serum 25-hydroxyvitamin D can be considered as a diagnostic biomarker for HCC, and its combination with alpha-fetoprotein could increase the diagnostic power. Vitamin D receptor Apa I CC genotype and Fok I ff genotype may be regarded as potential genetic risk factors for HCC development in Egyptian patients with HCVrelated liver cirrhosis. Clearly, further well-designed prospective studies are required to prove this hypothesis.