Thesis (Ph.D.) - Cairo University - Faculty of Science - Department of Biotechemistry

Background: simple score to discriminate HCC from patients with chronic liver diseases (CLD) is needed. The simplest score would be one that requires only variables that can be documented simply from routine laboratory tests without the need for sophisticated tests. Methods: HCC patients and liver cirrhosis (LC) patients (n=289) were enrolled in the first part of the study. Fibronectin (FN), cytokeratin-1 (CK-1), Epithelial membrane antigen (EMA) were identified in the blood using monoclonal antibodies and Western blot. Data of the estimation group 1351 patients and the validation group 2208 patients were retrospectively analyzed in the second part. Liver fibrosis as a negative control and liver cirrhosis were compared to HCC. Area under curve (AUC) was used to develop FACE score (FN+AFP+CK-1+EMA) and HCC-AFP-Routine Test (HCC-ART) score.Results: Molecular weights of FN, CK-1 and EMA were determined at 90, 67 and 130 kDa respectively in sera of patients with HCC and LC. FACE score with AUC 0.88 was obtained to discriminate HCC from LC patients. In the second part of the study we developed a much simpler & sensitive score composed of routine biomarkers in larger sample of patients

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