الفهرس 
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Abstract
In Egypt, HCC is the third most frequent cancer in men with > 8000 new cases predicted. Early detection of HCC opens doors for various effective treatments such as surgical resection, radiofrequency ablation, and transplantation, which can subsequently lead to long term survivals in a great number of HCC patients (56).
Recently, there has been a great interest in the roles of microRNA in the field of cancer research. Alterations of cancer tissue and circulating microRNAs have been shown in patients with HCC. However, there have been no reports on serum exosomal microRNAs in HCC (236).
Our results showed that:
This study was conducted on 20 newly diagnosed untreated HCC patients and 20 patients with liver cirrhosis due to HCV and HBV infection presented to inpatients wards and outpatient clinic of Hepatology department of Cardiac and digestive Institute, Sohag in the period from April 2018 and January 2019. In addition to 20 apparently healthy subjects matching age and gender of the patients served as a control group.
All patients and controls were subjected to complete medical history, clinical examination, laboratory studies as kidney function tests – liver function tests – CBC – ESR, serological markers as HCVAb and HBsAg, AFP, isolation of serum miRNA-21 and quantitative real time PCR and imaging studies as abdominal ultrasound and triphasic C.T. abdomen.
MicroRNA-21 was significantly higher in group I (18.69 ± 6.57) than group II (3.43 ± 2.0) and then group III (1.0 ± 0.0) with highly statistically significant difference between the three groups as (p<0.001) and also, at AUC 0.985, Micro RNA-21 had 95% sensitivity, 85% specificity, 86.4% PPV and 94.4% NPV between group I and II.
In group I, there was non-significant difference in micro RNA between cases with intermediate stage (A) (17.29 ± 7.32) and those with Early stage(A) (20.78 ± 4.94) as p=0.181
In group II, there was non-significant difference in micro RNA between cases without hepatic encephalopathy (3.79 ± 2.16) and those with hepatic encephalopathy (2.35 ± 0.77) as p=0.142
In group I, there was negative non-significant correlation between micro RNA and total bilirubin (r= -0.286 &p= 0.222) and INR (r= -0.122 &p= 0.609). On the other hands, there was positive non-significant correlation with albumin (r= 0.092 &p= 0.700). While in group II, there was negative non-significant correlation between micro RNA and total bilirubin (r= -0.286 &p= 0.296) and INR (r=-0.117& p= 0.625). On the other hands, there was positive non-significant correlation with albumin (r= 0.104 & p= 0.661).
There was significant difference in micro RNA between cases without ascites (2.85 ± 0.78), those with mild ascites (5.33 ± 2.60), those with moderate ascites (3.99 ± 2.17) and marked ascites (2.20 ± 0.55) as p= 0.039, this explains that there was no relation between Micro RNA-21 and amount of ascitic fluid.