الفهرس 
Review of literatureOnly 14 pages are availabe for public view
 |  | from | 187 |  |  |
| | | from | 187 | | |
Abstract
Primary and metastatic liver cancer continues to present a major challenge to patients, families, health care professionals and the community as a whole. The liver is one of the most common sites for metastatic disease, accounting for 25% of all metastases to solid organs. In the United States and Europe, secondary liver neoplasms are far more common than primary hepatic neoplasms. The two most common primary malignant liver tumours are hepatocellular carcinoma (HCC) and cholangiocarcinoma. Hepatocellular cancer is 10 times more frequent than cholangiocarcinoma and is one of the most common malignant neoplasms in the world. Physicians often face the problem to differentiate between primary and secondary liver malignancy and the instrumental techniques used to diagnose are not completely satisfactory. as computed tomography and magnetic resonance are not very efficient, and ultrasound-guided fine-needle aspiration or liver biopsies via laparoscopy are accurate but invasive. Also despite the fact that serum AFP is still the golden standard amongst diagnostic markers for hepatocellular carcinoma, its diagnostic value is more and more questioned, due to poor sensitivity and specificity. This study aimed to find rapid, sensitive, cost saving and non-invasive markers for the differential diagnosis between primary and secondary hepatocarcinoma that can provide valuable information to physicians for the optimal management of liver cancer either for diagnosis or prognosis or treatment strategy. Also it aimed to that if those parameters could predict the primary origin site for liver metastases without invasive techniques.The study included 60 individuals divided into 3 groups. First group suffered from hepatocellular carcinoma. Second group suffered from liver metastasis. Third group were healthy volunteers. Different serum biomarkers as AFP, Cancer embryonic antigen (CEA) level, 5’-Nucleotidase enzyme activity (5-NU), Leucine aminopeptidase enzyme (LAP) activity, free glucosamine (FGA) level, Free Total sialic acid (TSA) level, and Total glycosaminoglycans (TGAGs) level were measured. from results we can conclude that a new panel of parameters can be used to differentiate primary from secondary hepatocarcinoma in addition to AFP as CEA, TGAGs, TSA and FGA are markedly elevated in secondary hepatocarcinoma while LAP and 5’NU are elevated in primary hepatocarcinoma. Also we can rely on these parameters to expect to some extent the primary origin of secondary hepatocarcinoma whether it is colorectal or breast or lung as high level of all parameters could be due to colorectal origin while high levels in CEA, LAP, TSA, TGAGs, and FGA with normal values of AFP and 5’-NU could be due to breast origin and finally lung origin showed only high levels of TSA, TGAGs, and FGA while levels of CEA, LAP, AFP and 5’-NU are normal.