الفهرس 
Aim of the work
Insulin like growth factor (IGFs)Only 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is one of the most malignant tumors affecting human with increasing incidence in our locality. The precocious diagnosis is a critical point in management of patients with HCC.
In addition, liver transplantation is a promising treatment for patients with small tumors, while it lacks effectiveness when patients with HCC become symptomatic. The ultrasonography and measurement of serum AFP permit an early diagnosis of HCC.
However, AFP is not a sensitive screening marker for HCC in general population. Elevated serum AFP value in HCC patients was a common finding; however, still others had low or normal values. Because both false positive and false negative results are obtained when AFP is used as a serum marker for HCC, the search for other HCC markers is still continuous.
The present study was performed to estimate the level of serum Insulin like growth factor1 (IGF1) in HCC patients to evaluate whether IGF1 could be used in the diagnosis of HCC with success. In order to fulfill this purpose, serum IGF1 level in 50 HCC patients {(10 diabetic and 40 nondiabetic) including 28 HCC patients with normal or questionable positive level of AFP} was compared to 10 healthy subjects. Since patients in this study have HCC with cirrhosis and in order to nullify the effect of cirrhosis on IGF1 level, a group of 30 cirrhotic subjects without HCC (11 diabetic and 19 nondiabetic) was used. from this study, we can conclude the following: Serum IGF1 level was decreased in our HCC patients. Many factors contribute to this reduction, among of these are: liver damage as appear in the cirrhotic group, the level of other tumor cytokines as appear indirectly by measuring GAGs level, and diabetes.
Reduction in IGF1 level may contribute to many complications associated with cirrhotic and HCC patients, especially decrease in albumin level, increase in prothrombin time and decrease in Hb content & RBCs count. IGF1 is disturbed in liver cirrhosis and represents a good marker of hepatic function. Moreover, the development of HCC is accompanied by a significant reduction in serum IGF1 level, which can act as a marker for the diagnosis of the tumor especially in those patients with normal level of AFP.
Our results suggest that periodic measurement of serum IGF1 level may be useful for HCC screening and predicting the development of HCC in Egyptian patients with cirrhosis.