الفهرس 
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Abstract
The current prospective, analytical, case-controlled, hospital-based study was performed in the Internal Medicine Department in collaboration with the Biochemistry Department at Minia University Hospital along the period from April 2020 to May 2022.
This study was conducted on the following groups:
group I: It included 24 patients with HCV-related liver cirrhosis with HCC. The diagnosis of chronic HCV infection was based on the presence of anti- HCV and HCV RNA for 6 months or more. Liver cirrhosis was defined by clinical, laboratory, ultrasonography and upper endoscopic evaluation. The diagnosis of HCC was based on the characteristic imaging criteria.
group II: It included 24 patients with HCV-related liver cirrhosis without HCC.
group III: It included 24 apparently healthy volunteers.
The patients were recruited from the outpatient clinic and inpatients at the Internal Medicine Department at Minia University Hospital. Whereas healthy volunteers were randomly selected from the medical and paramedical staff of the same hospital. Informed consent was obtained from all the study participants, in accordance with the guidelines of Institutional Review Board of the Faculty of Medicine Ethical Committee, Minia University.
The exclusion criteria included patients with:
Causes of liver cirrhosis other than chronic HCV infection.
Solid tumors other than HCC
Hematological malignancies.
Immune- related diseases.
Chronic inflammatory diseases.
Allergic diseases.
Diabetes mellitus (DM), that was diagnosed according to the criteria of American Diabetic Association (2021).
End organ failure
Organ transplantation
Hepatic resection
Prior locoregional treatment of HCC.
All study individuals were subjected to the following: I-Thorough clinical history
Careful clinical examination with special emphasis on:
Vital signs, stigmata of chronic liver disease, and other body systems were examined as well.
laboratory investigations; including:
1- Complete blood count (CBC). 2- Complete liver function tests.
3-Prothrombin concentration (PC) and international normalized ratio (INR).
4 -Fasting and 2-hour post-prandial blood glucose levels (FBG, 2h- PPBG).
Viral markers: including: anti-HCV, HbsAg and anti-HIV.
Alpha-fetoprotein (AFP) in HCC group.
Determination of blood level of lncRNA Taurine up- regulated gene 1 (lncRNA- TUG-1) that was assessed by quantitive polymerase chain reaction (q- PCR), the relative expression level of lncRNA-TUG-1 was normalized against that of the GAPDH.
Imaging studies:
Abdominal ultrasonography
Abdominal contrast-enhanced Computerized Tomography scanning.
Assessment of functional status of the liver using: MELD (Kamath et al., 2007) and Child-Pugh (Child & Turcotte, 1964) scoring systems in cirrhotic patients.
Staging of HCC that was based on: Tumor Node and Metastasis (TNM) (Kee et al., 2013) and Okuda (Okuda et al., 1985) staging systems.
LncRNA-TUG-1 expression was significantly higher in HCC patients than cirrhotic and control groups. This suggests its role in the pathogenesis of HCV- related HCC. Moreover, this expression was related to the tumor aggressiveness, worse outcome and outstanding efficacy in the diagnosis at an optimal cutoff value of > 1.57 which yielded a sensitivity of 100%, specificity of 91.67%, PPV of 92.3%, a NPP of 100% and diagnostic accuracy of 95.83%.