Cholangiocarcinoma (CCA) is a rare tumor comprising approximately 3% of gastrointestinal tumors with an overall incidence of less than 2/100 000. It is the second most common primary hepatic malignancy following hepatocellular carcinoma (HCC). 1,2 CCA incidence has been increasing globally during the last decades, where its incidence increases with age. 3 According to the anatomic location, CCA is classified into intrahepatic (IH-CCA) and extrahepatic (EH-CCA) where the later accounts for 80%-90% of all cases. 4 The commonest risk factors for CCA are primary sclerosing cholangitis (PSC), 5 chronic liver disease (including chronic viral hepatitis B and C), 6 and intrahepatic stones (hepatolithiasis). 7 CCA patients remain clinically silent until the advanced stages of the disease. The common clinical feature of EH-CCA is biliary obstruction resulting in painless jaundice, while IH-CCA presents in most cases
Background. Ghrelin is a gastro-duodenal hormone which plays a major role in the regulation of food intake, energy balance and gastrokinesis. Ghrelin represents a novel biological marker for assessment of the presence as well as the severity of liver cirrhosis. We aimed to measure the level of plasma ghrelin in patients with liver cirrhosis (compensated and decompensated) and to correlate its level with different studied clinical and laboratory parameters. Subjects and methods. 40 cirrhotic patients were included in a cross-sectional study and divided equally according to the Child-Pugh classification into Group I: patients with compensated liver cirrhosis (Child A), and Group II: patients with decompensated liver cirrhosis (Child B|C). Also, 20 age and sex matched healthy subjects were included as a control group (Group III). All patients were subjected to: full history taking, full clinical examination, routine biochemical studies together with estimation of plasma ghrelin level, assessment of the severity of liver disease according to Child-Pugh classification, also, abdominal ultrasonography was done. Results. Plasma ghrelin level was low among cirrhotic patients (both compensated and decompensated) in comparison to normal control subjects. Conclusion. Ghrelin can be used as a serum biomarker for detection and assessment of the severity of liver cirrhosis.
mtDNA content analysis could serve as a noninvasive molecular biomarker that reflects tumor burden in HCV-HCC cases and could be used as a predictor of HCC risk in patients of HCV-cirrhosis. In addition, the nonsignificant difference of mtDNA level between HCV-cirrhosis patients and healthy controls could eliminate the gray zone created by the use of alpha-fetoprotein in some cirrhotic patients.
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