Detection of helicobacter pylori in hepatic tissue of patients with chronic hepatitis c and hepatocellular carcinoma: [immunohistochemical study]

Recent studies have suggested that bacterial coinfection with Helicobacter species in patients already infected with hepatitis C virus [HCV] could be involved in the development of cirrhosis and hepatocellular carcinoma [HCC]. A retrospective study was performed in order to explore the association between Helicobacter pylori and HCV in hepatic tissue of Egyptian patients with chronic hepatitis C and hepatocellular carcinoma. The presence of Helicobacter pylori was tested by immunohistochemistry on liver samples from two groups of patients; chronic hepatitis C [group I, n = 45] and hepatocellular carcinoma [group II, n = 15]. Group I [chronic hepatitis C] involved 31 males and 14 females [male/female, 2.2:1]. Their age ranged from 27 to 58 years with a mean of 45.8 +/- 7.0 years and HCC group involved 11 males and 4 females [male/female, 2.8:1]. Their age ranged from 48 to 78 years with a mean of 60.2 +/- 10.0 years. Immunostaining revealed H. pylori microorganisms in 33/45 biopsies [73.3%] of chronic hepatitis C group and 5/15 [33.3%] of HCC group [p = 0.005]. H. pylori organisms were present in liver tissues of HCV and HCC patients with significantly higher proportion in the former. Further studies are needed to ascertain its possible role, if ever, in the pathogenesis of cirrhosis and hepatic malignancy in Egyptian patients

Histopathological features of chronic hepatitis C in Egyptian patients

Chronic liver disease including that caused by the hepatitis C virus progresses in stages. It can range from inflammation, to fibrosis to end stage liver disease or liver cancer. This work aimed to study the histopathological features of chronic hepatitis C infected Egyptian patients followed-up at National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt. The study included 4267 liver biopsies from patients with serological and virological diagnosis of chronic HCV with no other identifiable cause for liver disease, signs of hepatic decomposition, or other significant non-hepatic disease. All biopsies were fixed in formalin, embedded in paraffin, and sectioned by microtome with a thickness of 5 micro m. Routine specimen processing involved staining slides with hematoxylin and eosin [5 levels] and Masson's trichrome stain [5 levels], for a total of 10 levels per specimen. All levels were screened by two pathologists to ensure the histological abnormalities. Ishak scoring system was applied for assessment of fibrosis and necroinflammatory injury. The percentage of hepatocytes involved by fatty changes was used to score the grade of steatosis. The relations between the histopathological findings, age and sex of the patients were carried out. The studied group [n = 4267] involved 3268 males and 999 female, with age ranging from 21 to 60 years and a mean of 41.7 +/- 9.7 years. Necroinflammatory activity of the virus was minimal in 17.88%, mild in 56.41%, moderate in 22.24% and severe in 3.47%. No fibrous tissue deposition was seen in 21 patients [0.49%], 27.32% of the patients had portal and periportal fibrous expansion, 27.91% had fibrous extensions with occasional thin fibrous tissue bridge, 36.28% had frequent broad fibrous tissue septa, while 7.99% of the studied group of patients had cirrhosis. Steatosis was absent in 52.45% of cases, mild in 39.75%, moderate in 7.19% and severe in 0.61% of patients. Non-specific granulomatous reaction was detected in 11 liver biopsies [9 males and 2 females]. Fibrosis and necroinflammation were more frequent in older patients. No significant difference between males and females regarding fibrosis, but females were more exposed to higher grades of necroinflammation [p < 0.001]. Chronic hepatitis C infection is a common and serious health problem that progresses to fibrosis, cirrhosis, liver failure and hepatocelluar carcinoma. Portal lymphoid infiltrate and minor hepatocellular necrosis were present in almost all cases. Necroinflammatory activity was mild in nearly half of the cases. Steatosis was detected in 47.55% of the patients. Fibrosis and necroinflammation were more frequent in older patients. Non-specific granulomas were rarely encountered in association with hepatitis C

Effect of garlic on tumor invasion and metastatic potential in induced colon carcinogenesis in rats: histopathological and immunohistochemical study

Preventive intervention of colorectal cancer has become essential as a major portion of the population may develop the disease at some points during their lives. Diet and nutrition play an important role during this multi-step colon carcinogenic process. Inhibitory activity of garlic was tested on Dimethylhydrasin [DMH] induced colon carcinogenesis in Sprague-Dawley rats. Experimental study was done to investigate the mechanism of garlic action on occurrence of colon neoplasia and liver metastasis as well as the expression of cyclooxygenase-2 [COX-2], matrix metalloproteinase [MMP-2] and CD34 was analyzed in the colonic mucosa. On histopathological examination of colon and liver of the investigated animals, the first [normal control] as well as the fourth group [receiving garlic only] revealed no pathological lesions. In the 2nd group [taking DMH only], colon neoplasia was detected in 21/21 [100%] of animals and liver metastasis in 10/21 [47.6%] while, in the 3rd group [receiving DMH and garlic], the tumor occurrence was detected in 16/32 [50%] of animals with no liver metastasis. Following treatment with garlic, significant suppression of COX-2, MMP-2 expressions [p<0.01] was detected with respect to the carcinogen group. As regards angiogenesis in DMH treated animals, CD34 expression was mostly of grades III and IV compared to grades 1 and II in combined DMH and garlic treated group. It could be concluded that the observed modulatory influences of garlic at the level of suppression of COX-2, MMP-2 and CD34 during DMH induced colon carcinogenesis suggest that the dietary intake of garlic has a chemopreventive and inhibitory effects through the multi-step carcinogenesis

Des-gamma carboxy prothrombin: a useful reliable early marker for detection of hepatocellular carcinoma

Hepatocellular carcinoma [HCC] is one of the most common cancers in the world. The early detection is important in the management of cancer. Des-gamma carboxy prothrombin also called protein induced by vitamin K absence or antagonist II [PIVKA II] has attracted attention as a marker for early diagnosis of HCC. to assess a diagnostic role of PIVKA II for early detection of HCC. The present case control study included 50 patients who fulfilled criteria for inclusion, with an age ranged from 30-60 years of both sexes. They were selected from outpatient clinic of the National Hepatology and Tropical Medicine Research institute [NHTMRI] from January 2003 to July 2004. Twenty age and sex matched subjects were used as controls. Patients were classified into 3 groups: Group I: 22 cases with HCC, Group EL: 15 late cases of decompansated liver cirrhosis, Group III: 13 early cases of liver cirrhosis. All patients were subjected to proper history taking, thorough clinical examination, and Laboratory investigations: complete blood picture [CBC], erythrocyte sedimentation rate [ESR], coagulation profile, liver function test and kidney function test. Determination of plasma PIVKA II, serum alpha fetoprotein [AFP] and serum ferritin were done by an ELISA technique. The collected data were computerized and analyzed statistically. The present study showed that level of- plasma PIVKA II was highly significantly increased in group I compared to the other groups [p < 0.01]. Group III showed a significant difference compared to control group [p < 0.05]. Serum AFP was highly significantly increased in group I compared with other groups [p < 0.01]. Also group II and group III showed a significant difference in serum AFP than control group. Serum ferritin was significantly higher in group I and group II than controls [p < 0.01]. Group II showed a significant increase in serum ferritin than group III [p < 0.05]. Plasma PIVKA II is a reliable marker of HCC that can be used with AFP as a complementry test for early detection of HCC in patients with cirrhosis