الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Chronic liver injury causes inflammation and hepatic fibro¬sis. Regardless of the cause, this can lead to the formation of fibrous septae and nodules, collapse of liver structures, and distortion of hepatic parenchyma and vascular architec¬ture. Progressive fibrosis and cirrhosis subsequently result in decreased metabolic and synthetic hepatic function, causing a rise in bilirubin and decreased production of clot¬ting factors and thrombopioetin. Cirrhosis can result from chronic liver damage of any cause and this can lead to hepatocellular carcinoma (HCC).
HCC is the commonest type of primary liver cancers that accounts for about 90% of cases and most patients are diagnosed in advanced or terminal stages with poor prognosis. So, it is reported as thethird leading cause of cancer death worldwidely. Furthermore, cirrhosis is a chronic liver disease characterized by fibrosis and impaired liver function is a major risk factor for the development of HCC. Therefore, it is crucial to establish new clinical markers for early HCC diagnosis and staging. Liver cancer is still a life-threatening disease which is expected by 2025 to affect annually more than one million individuals.
Hypoxia is a common characteristic in metastatic tumors where hypoxic regions are characterized by low oxygen content in addition to an acidic extracellular pH. Hypoxia in tumors is a known risk factor for poor prognosis and resistance to therapy. Therefore, carbonic anhydrase IX (CA9) has gained interest as a biomarker in malignancies.