الفهرس 
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Abstract
Cirrhosis is the end stage of every chronic liver disease, resulting in formation of fibrous tissue, disorganization of liver architecture and nodule formation.
Hepatocellular carcinoma (HCC) is believed to be one of the most challenging tumors with rising incidence, prevalence and mortality rates. It is globally the fifth most frequently diagnosed cancer worldwide, and is the second leading cause of cancer-related death in the world. It was reported that HCC is rapidly progressive and aggressive in biological behavior with an ultimately poor prognosis. Moreover, the majority of HCC patients had underlying chronic liver diseases mostly liver cirrhosis. It is well known that hepatocellular carcinoma (HCC) develops as a consequence of hepatic fibrosis progression. Eight readily available blood indices King score, Fibro Q, AST-ALT ratio (AAR), APRI, LOK index, Goteborg University Cirrhosis Index (GUCI), fibro alpha, and Biotechnology Research Center (BRC) were constructed to compare the accuracies of these non-invasive scores in predicting HCC development.
The aim of this study was to assess the role of fibro markers in prediction of hepatocellular carcinoma in chronic liver disease patients. Adult patients included in the study of both sex who have liver cirrhosis above 18 years old and patients of liver cirrhosis with HCC after exclusion of
1-Extrahepatic intraabdominal malignancy.
2- HCC with distant metastasis.
3- Pregnant female.
4- Previous intervention of HCC.
5- Alcoholic liver disease
6- Age < 18 years
The study included 100 patients with HCV+ve liver cirrhosis (group 1) and 100 patients with HCV+ve liver cirrhosis and HCC (group 2).
All patients in the study were subjected to history taking and clinical examination for symptoms and signs of chronic liver disease, routine laboratory investigations (as CBC, liver profile, kidney functions,), abdominal ultrasound and triphasic abdominal CT. Eight readily available blood indices King score, Fibro Q, AST-ALT ratio (AAR), APRI, LOK index, Goteborg University Cirrhosis Index (GUCI), fibro alpha, and Biotechnology Research Center (BRC) were constructed.
The following parameters showed statistical significant difference between cirrhotic patients group (1) and cirrhosis with HCC patients group (2)
1- KING score was significantly higher in group 2 than group 1 (P.value = 0.033).
2- Fibro Q was significantly higher in group 2 than group 1.(P. value = 0.005).
3- FIB 4 was significantly higher in group 2 than group 1 ( P. value = 0.005).
4- BRC score was significantly higher in group 2 than group 1 (P .value = 0.0001).
5- Fibro alpha score was significantly higher in group 2 than group 1(P. value = 0.0001).
On the other hand the following parameters such as Guci score, LOK index score, AAR and APRI score showed non-significant difference between cirrhotic patients group 1 and cirrhosis with HCC patients group 2.
The frequency of ascites, hepatic encephalopathy, and hematemesis was significantly higher in HCC patients compared to chronic HCV patients this explained that HCC development is a leading cause for deterioration of chronic liver disease patients.