Background: Hepatocellular carcinoma (HCC) has an increasing incidence worldwide, and is considered the second cause of cancer-related death. Aim: The aim of the study is to assess the usefulness of real-time shear-wave elastography in differentiating HCC from other hepatic focal lesions. Patients and methods: The current study was conducted on 110 patients in addition to 10 healthy subjects, divided into four groups as follows: liver cirrhosis, HCC, hepatic focal lesions other than HCC, and control. Demographic, laboratory and imaging data were collected and then elastographic assessment of the hepatic focal lesions and the surrounding liver parenchyma using elastograph point quantification (ElastPQ) (iU22x MATRIX, Philips) was done. Results: ElastPQ (iU22x MATRIX, Philips) has shown its ability to differentiate between HCC and cystic focal lesions, HCC and cholangiocarcinoma, and HCC and focal nodular hyperplasia (FNH). Cystic lesions demonstrated lower stiffness in comparison to HCC; however, cholangiocarcinoma and FNH demonstrated higher stiffness in comparison to HCC. ElastPQ was unable to differentiate between stiffness in both ‘HCC and hemangioma’ and ‘HCC and metastatic focal lesions’. ElastPQ showed that HCC, cystic focal lesions, and cholangiocarcinoma had lower stiffness in comparison to their surrounding liver parenchyma, whereas FNH had higher stiffness in comparison to the surrounding liver parenchyma. ElastPQ showed that the surrounding liver parenchyma of the HCC group has the highest stiffness amongst all studied hepatic focal lesions surrounding liver parenchyma. Conclusion: ‘Point’ shear-waves elastography (ElastPQ; Philips iU22x MATRIX, Philips) is a noninvasive, quantitative and nonradiating method for evaluation of tissue elasticity, and is helpful in differentiating HCC from other hepatic focal lesions.
Background: HCC accounts for 90% of all primary liver cancers around the world. HCC is the fifth most frequent cancer in the world and the second largest cause of cancer-related death. HCC will be the first indication for liver transplantation by 2030. The need for a marker to detect HCC cases early is critical. Melatonin is a hormone, and when its hemostasis is disrupted by cirrhosis, it may be linked to the development of hepatocellular carcinoma. The aim is to assess blood melatonin levels in patients with liver cirrhosis (compensated and decompensated) and HCC. Subject and Methods: This was a comparative cross-sectional study with 22 patients with compensated liver cirrhosis, 22 patients with decompensated liver cirrhosis, 22 patients with HCC, and 22 healthy subjects as a control group. Laboratory tests, as well as abdominal ultrasound and spiral CT, were performed as needed.Melatonin levels were measured using an ELISA kit in accordance with the manufacturer's instructions. Results: In compensated liver cirrhosis, there was a statistically significant positive correlation between serum melatonin and age, as well as a significant positive correlation between melatonin, (Hb), (WBCs), and (platelets) in decompensated liver cirrhosis. Serum melatonin has low statistical sensitivity, specificity, and predictive value. Conclusion: The melatonin levels in the compensated, decompensated and HCC groups were lower than in the control groups, the difference was not statistically significant.
Hepatocellular carcinoma (HCC) represents about 90% of primary liver cancers. In Egypt, it represents the fourth common cancer. Main risk factor for HCC is cirrhosis of the liver that caused by different causes including viral hepatitis, alcohol, non-alcoholic fatty liver disease (NAFLD), metabolic, autoimmune liver disease, and Aflatoxin.As many types of cancer, aberrant lipid profile may be present in HCC patients which may be related to aggressiveness of the tumor. Aim: To evaluate the association between serum lipid profile abnormalities and the aggressiveness of HCC. Methods: One hundred and fifty participants were included in the study, divided into three groups: sixty patients with HCV related chronic liver disease, sixty patients with HCC diagnosed by ultrasound and confirmed by Triphasic CT and thirty apparently healthy individuals as a control. All participants were subjected to: full history taking, full clinical examination, laboratory investigations (CBC, RBS, ESR, serum creatinine, liver profile and lipid profile "total cholesterol, TG, LDL, HDL, VLDL, HDL\ LDL ratio") and radiological examination (ultrasound, Triphasic CT). Results: The results showed that HCC patients had low total cholesterol, HDL, LDL compared to normal group. LDL had weak positive correlation with the combination of all four tumor aggressiveness parameters together. The mean HDL was significantly higher in those with portal vein thrombosis (PVT) than those without in HCC patients. Conclusion: Hepatocellular carcinoma (HCC) patients had low levelof serum lipid profile (TC, HDL, and LDL), Plasma LDL had weak positive correlation with aggressiveness index, and HDL was significantly higher in those with PVT.
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