RESUMEN
Hepatocellular carcinoma [HCC] is the most common primary malignant tumor of the liver. Liver cirrhosis regardless its etiology is the most powerful risk factor for HCC. Transforming growth factor beta-1 [TGF- beta 1] is an important cytokine involved in cell growth, inflammation and hepatic fibrosis. It's also involved in both tumor promoting and suppressing activities. The aim of this work was to determine the alterations in the expression of TGF - beta 1 in cirrhotic patients with and without HCC and to study TGF - beta 1 gene polymorphisms [C-509 T and leu 10 pro] and their associations with the risk of HCC in cirrhotic patients. This work was done on 15 patients with cirrhosis and 15 patients with HCC on top of cirrhosis, and 10 healthy individuals as control group. Alpha fetoprotein [AFP], abdominal ultrasound, triphasic C.T, liver biopsy and TGF- beta 1 expression were done for all patients and controls. There was statistically significant increase in the level of TGF- beta 1 expression in both cirrhosis and HCC groups as compared to control group with higher level of expression in cirrhotic group than HCC group. The frequency of CC genotype of C-509 T and of Leu/Leu genotypes at codon 10 was higher among patients with HCC than in cirrhotic patients and control. As regards to allelic variations, C and/or Leu allele carriers were at higher relative risk for HCC compared with T and/or Pro allele carriers. There was higher expression level of TGF- beta 1 in patients carrying T or Pro allele whether heterozygous or homozygous than those carrying homozygous C or Leu allele. TGF-beta 1 expression may play a role in the pathogenesis of cirrhosis and HCC. It may also be involved in the progression of cirrhosis to HCC. TGF- beta-1 alleles, C at position - 509 and /or leu of codon 10 may be genetic risk factors for HCC in cirrhotic patients. So frequent screening of such patients for HCC is recommended