الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Introduction and aim of work: Hepatocellular carcinoma (HCC) is the sixth most common neoplasm and the third most frequent cause of cancer death, developed mainly in liver cirrhosis. Hepatitis B (HBV) or C virus (HCV) chronic infections account for 75% of HCC whereas non-viral etiologies as alcohol, genetic or metabolic disorders represent less than 25% of cases. Interaction between AGES and their receptor RAGE lead to cellular activation and thus prolonged inflammation and apoptosis .We aimed in our study to elucidate the association between serum level of AGEs and the risk of development of hepatocarcinogenesis in patients with chronic hepatitis C (CHC) which are non diabetics.
Patients and Methods: we recruited 50 HCV_associated HCC Patients (group 2) compared with two different groups : one consisted of 26 CHC patients (group 3) and the other consisted of 50 healthy subjects as a control group (group 1). Venous blood samples from the three groups were taken after 12 hours overnight fasting to assess liver function tests, complete blood count, international normalized ratio, total cholesterol, , triglycerides, glucose, insulin, hepatitis B surface antigen (HBsAg) ,antibody to hepatitis C virus (anti-HCV) and serum level of AGEs. Insulin resistance was then investigated in all patients by the homeostasis model for the assessment of IR (HOMA-IR) using the standard formula: HOMA-IR = fasting insulin (µIU/mL) x fasting glucose (mmol/L)/22.5.
Results: Patients of HCV-related HCC group showed significantly high levels of insulin, glucose, HOMA-IR and serum levels of AGEs and lower levels of total cholesterol, triglycerides compared to the other two groups.
AGEs correlated positively with ,bilirubin level (p value =0.017) and level of fasting blood glucose (p value =0.08) , However there was significant negative correlation between AGEs and serum albumin level (p value =0.010,r=-0.361),and there was no correlation with other parameters like age, male sex ,BMI , cholesterol, TG, liver enzymes , Hb level ,WBCs and platelets number .
There was no correlation between AGEs level and number of hepatic focal lesions (p value =0.882) and also no correlation between AGEs and size of these focal lesions (p value =0.137)
Also, there was positive correlation between level of AGEs and grade of hepatic decompensation according to Child score the results were (p value =0.012, 0.001, 0.014) between Child class A and B, Child B and C, Child A and C respectively in the group of HCC patients.
Based on ROC Curve analysis using cut-off point >81 ng /ml AGEs sensitivity was 92%, while specificity 84.62%, AUR was 0.95 and p<0.001.