الفهرس 
Introduction& Aim of the workOnly 14 pages are availabe for public view
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Abstract
The current study was performed at AL-Rajhy Liver Hospital in the period between June 2018 and April 2019. A Total 98 chronic HCV patients included in the study and they were classified into chronic HCV infection (n = 22), HCV-related cirrhosis (n = 22) and HCV-related HCC (n = 54). Mean age of the studied patients was significantly higher in patients with Hepatocellular carcinoma (HCC) compared to patients with chronic hepatitis C viral infection (CHC) (p-value = 0.01) and also, higher than patients with liver cirrhosis (LC) (p-value = 0.01) and the majority of patients in all studied group was males but frequency of male sex was significantly higher in patients with HCC (90.7%) and patients with LC (72.7%) compared to patients with CHC (50%). The results showed that Child score and meld score were significantly higher among LC patients compared to HCC patients (p-value < 0.001) and (p-value = 0.04), respectively. Alpha fetoprotein was significantly higher among patients with HCC compared to patients with CHC and LC (p-value < 0.001). All HCC patients had LC with median number of hepatic focal lesion was 2 with range between 1 and 3 focal lesions. Mean size of focal lesion was 4.52 ± 2.34cm3. Based on BCLC staging, 10 (18.5%), 15 (27.7%), 20 (37%), and 9 (16.7%) patients had stage 0, stage A, stage B and stage C, respectively. The study of mi-RNAs levels in different groups showed that serum levels of miR-21 and miR-222 were increased with a progressive course from chronic hepatitis to cirrhosis and hepatocellular carcinoma (p-value < 0.001). MiR-21 at cutoff point >23.49, had 61.11% sensitivity and 95.44% specificity for prediction of HCC with diagnostic accuracy was 76.5% and miR-222 at cutoff point >13.8, had 71.7% sensitivity and 93.18% specificity for prediction of HCC with diagnostic accuracy was 81.6%. While the serum levels of miR-122 were significantly decreased in HCC group compared to other groups (p-value < 0.001) and had 98.15% sensitivity and 100% specificity for prediction of HCC at cutoff point <10.18, with diagnostic accuracy was 99% while insignificant difference as regarding miR-122 serum levels between CHC group and LC group (p-value = 0.88). All the studied groups had insignificant difference in levels of the studied microRNAs between the patients who received DAAs and those not received treatment except HCV group showed that miR-222 was significantly higher in patients who didn’t receive antiviral therapy compared to patients who received DAAs (P-value = 0.03) but this result is limited by the small number of the patients included in this group. large-scale multi-center studies exploring a panel of miRNAs for a more sound conclusions and recommendations regarding surveillance for HCC. Further analyses and new technology for miRNA research will elucidate novel concepts in the pathogenesis of HCC. Analyzing miRNA profiles and their signaling pathways offers deeper insights into the treatment options for HCC and prediction of response to treatment. Study of miRNA profiles in liver diseases other than those related to HCV infection. Follow up miRNA levels in HCC patients to study it’s prognostic value in those patients.