Background In Egypt, the prevalence of chronic hepatitis C (CHC) infection is 13.8% of whole population and about 80% of the patients with hepatocellular carcinoma have underling hepatitis C. Aim This study was designed to assess the diagnostic value of plasma miR-122 and miR-21 in patients with CHC, genotype-4, to detect fibrosis progression versus noninvasive indices and their diagnostic value in detection of early stages of hepatocellular carcinoma (HCC). Methodology A prospective study that included 180 patients, divided into 3 groups: healthy controls (group I), CHC patients (group II), and hepatitis C patients with HCC (group III); all cases were subjected to thorough clinical, radiological, and laboratory investigations. Selected biomarkers were evaluated and correlated with degree of liver damage. Results revealed that miR-122 followed by miR-21 had the highest efficiency in prediction of liver cell damage. Also, miR-21 was strongly correlated with vascular endothelial growth factor (VEGF) and alpha fetoprotein (α-FP) in HCC patients. Conclusions Plasma miR-122 and miR-21 had strong correlation with degree fibrosis in HCV genotype-4 patients; consequently they can be considered as potential biomarker for early detection of hepatic fibrosis. Moreover, miR-21 can be used as a potential biomarker, for early detection of HCC combined with VEGF and α-FP.

The study concluded safety of total clipless laparoscopic cholecystectomy using a harmonic scalpel in Child A and B type cirrhotic patients, who presented with complicated gallstones.

Background This is a prospective study of 44 patients having 57 hepatocellular carcinoma (HCC) lesions indicated for transarterial chemoembolization (TACE) and a control group of 41 patients having 55 HCC lesions. TACE in the study group was performed on an angiography machine with an installed automated feeder detection (AFD) software (EmboGuide; Philips Healthcare, Best, The Netherlands) and in the control group was performed on a similar angiography machine (ALLURA XPER FD 20, Philips, Holland), but lacking the AFD software. The aim is to evaluate the clinical utilization of cone-beam CT (CBCT) and (AFD) software in accurate detection of (HCC) arterial feeders, the effect of (AFD) software utilization on the outcome of (TACE) and its utilization effect on fluoroscopy time and radiation dose to the patient during the (TACE) procedure. Results The highest percentage of agreement was between the number of arterial feeders detected by EmboGuide and the actual number of feeders detect during embolization reaching 91.2% with p value < 0.001. The residual non-intended non-embolized areas among the study group at 1-month follow-up were found in 2 out of 57 lesions compared to 9 out of 55 lesions in the control group. The average dose-area product (DAP) among the study group was less than that of the control group. Conclusion CBCT using AFD software provides more information about tumor feeders with consequent more efficient targeted embolization, higher success rate of TACE and less patient exposure to radiation.

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Aim of the study: Homeobox transcript antisense intergenic RNA (HOTAIR) is a long non-coding RNA classified as an oncogene and has been implicated in liver cancer initiation and progression. This study investigated the clinical usefulness of serum HOTAIR to predict hepatocellular carcinoma (HCC) and prefigure the tumor stage. Material and methods: This study included 80 patients with de novo HCC divided into 40 late-stage HCC patients (group IA) and 40 early-stage HCC patients (group IB), 40 patients with non-tumorous liver cirrhosis (group II), and 20 healthy controls (group III). Serum HOTAIR was measured using real-time quantitative polymerase chain reaction. Serum α-fetoprotein (AFP) was measured via enzyme-linked immunosorbent assay. Results: Serum HOTAIR was significantly higher in groups IA, IB and II compared to healthy subjects. Serum HOTAIR was significantly higher in group IA than group IB, and in groups IA and IB compared to group II. Serum HOTAIR at cut-off value > 15.45 (AUC = 0.71) showed 66% sensitivity and 78% specificity in discriminating HCC patients of group IB from HCC patients of group IA. When combined with AFP, the discriminative sensitivity and specificity increased to 74% and 90% respectively (AUC = 0.85). Serum HOTAIR at cut-off value > 9.42 (AUC = 0.823) showed 67.5% sensitivity and 93.3% specificity in discriminating HCC patients of group IB from patients with non-tumorous cirrhotic liver. When combined with AFP, the discriminative sensitivity and specificity increased to 80% and 98.3% respectively (AUC = 0.954). Conclusions: Circulating HOTAIR is a potential biomarker which may be used solely, or preferably in combination with AFP, to help HCC detection in cirrhotic liver and prefigure the tumor stage.

Purpose: The study was conducted to assess possible epidemiological, clinical and laboratory factors predicting the aggressiveness of Hepatocellular carcinoma (HCC) in HCV-related liver cirrhosis patients. Methods: A comparative hospital-based cross-sectional study was conducted. Exclusion criteria were HBsAg positive patients, and patients undergoing any treatment modalities for HCC. Complete history was taken focusing on signs and symptoms of the chronic liver disease, and clinical examination was done. Results: Among 173 patients, only 14.4% of the patients were classified as Child A. In near percentages, patients with Child B represented 43.4%, and patients with Child C were 42.2% of the studied patients. Most of the patients were males (75.7%), while the rest were females (24.3%). Patients were divided to 2 groups: group (I) included 36 patients with non-aggressive HCC (score = 4), and group (II) included 137 patients with aggressive HCC (score &gt; 4) according to the aggressiveness index (AgI) described by Carr et al that takes in count AFP, Maximum Tumor Diameter, number of nodules and presence of portal vein thrombosis. HCC patients in group (II) were 1.9 times more likely to have positive HBc Ab as compared to patients in group (I) where (OR = 1.9, CI = 1.3 - 3.6). Multiple logistic regression analysis for predicting the aggressiveness of HCC explains that 86.7% of factors (age, Child Pugh score, BCLC staging, Gamma glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), Platelets, HBcore ab and AFP) were contributing to aggressiveness among HCC-Hepatitis C related cirrhosis patients (R 2 = 0.867) with overall significant where chi-square = 21.876, p = 0.001. Conclusion: In conclusion, age, platelets, Child Pugh score, BCLC staging, HBcore ab, ALP, GGT and AFP are significant predictors for the aggressiveness of HCC. Citation Format: Randa Salah Abd Elmoneim, Fathalla Sedki, Aida Mohey, Ehab Hassouna, Eman Tayae. Factors Affecting the Aggressiveness of Hepatocellular Carcinoma among Hepatitis C Related Cirrhosis Patients [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 50.

This study explained the c-myc and p53 gene expression and polymorphisms in chronic (40), cirrhosis (30) and Hepatocellular Carcinoma, (HCC) (30) patients related to Hepatitis B Virus (HBV) infection and healthy control (50) in Egypt. Where, c-myc (intron 8) and p53 (codon 72) gene expression and polymorphisms were determined using qRT-PCR and PCR-RFLP techniques. The results showed that c-myc gene expression (2 ddct) was significantly increased in chronic (1.38), cirrhosis (1.47) and HCC (5.59) compared to the control group (1.00), while p53 gene expression (2 ddct) was significantly decreased compared to the control group (0.82, 0.65, 0.33 and 1.00, respectively). In HCC group, c-myc genotype (CC) was predominant (90%) more than cirrhosis, chronic and control (73.33, 22.5 and 6%, respectively), GG genotype was predominant in control (70%) more than chronic, cirrhosis and HCC groups (67.5, 6.66 and 6.66%, respectively) and GC genotype was high in control (24%) more than cirrhosis, chronic and HCC groups (20, 10 and 3.33%, respectively). p53 PP (88%) genotype was predominant in control more than chronic, cirrhosis and HCC groups (30, 30 and 6.66%, respectively), AA genotype was predominant in HCC group (73.33%) more than chronic, cirrhosis and control (50, 10 and 4%, respectively) and genotype PA was predominant in cirrhosis (60%) more than chronic, HCC and control (20, 20 and 8%, respectively). These results suggest clearly that both c-myc and p53 gene expression and polymorphisms influence clinical outcome and progression of HBV infection and then considered an accurate genetic biomarker to determine and predict the progression of HBV infection.

ObjectiveConflicting results have been reported by numerous epidemiological studies investigating the association between Helicobacter pylori (H. pylori) infection and inflammatory bowel disease (IBD). We aimed in this study to assess the possible association between H. pylori infection and IBD and its effects on disease progression.DesignProspective observational study.SettingSpecialised IBD care clinics at Alexandria University Student Hospital in northern Egypt, between March and June 2019.Participants182 patients with IBD.Analysis and outcome measuresParticipants with IBD were screened for H. pylori infection and clinically evaluated at the initial visit and bimonthly for 3 months to record any potential improvement/flare of the IBD condition.ResultsOverall, 90 (49.5%) patients with IBD had evidence of H. pylori infection. The course of IBD did not significantly differ in association with H. pylori infection or IBD treatment strategy. Cox regression analysis revealed that patients aged 20–35 years (HR=6.20 (95% CI: 1.74 to 22.12)) and 35–55 years (557.9 (17.4–17 922.8)), high socioeconomic status (2.9 (1.11–7.8)), daily consumption of fibre-rich food (5.1 (1.32–19.5)), occasional consumption of snacks between meals (2.8 (2.5–70.5)) and eating four meals per day (13.3 (1.0–7.7)) were predictive of IBD flare. By contrast, eating fruits and vegetables showed a strongly protective association (HR=0.001 (95% CI: 0.0002 to 0.02)). The probabilities of improvement of IBD symptoms after 12 weeks of follow-up were comparable in assessments based on H. pylori infection status (0.793 for H. pylori negative vs 0.778 for H. pylori positive) and IBD treatment option (0.811 for conventional therapy vs 0.750 for biological therapy).ConclusionThe association between IBD and H. pylori infection is unresolved and should be further investigated in the context of specific environmental exposures that can influence the development or relapse of IBD.