Résumé
Hepatocellular carcinoma [HCC] is one of the most common cancers worldwide affecting one million cases per year. The aim of the present study was to evaluate the diagnostic role of plasma matrix metalloproteinase-9 [MMP-9] in patients with HCC and its relation to hepatocyte growth factor [HGF]. This study was conducted on 30 patients classified into: Group II included 10 patients with chronic active hepatitis. Group III included 10 patients with liver cirrhosis and Group IV included 10 patients with HCC. Ten healthy subjects were also included in the study as a control group [group I]. Alt studied groups were subjected to clinical, laboratory, ultrasonographic examination and estimation of serum alpha-fetoprotein [APP], HGF and plasma MMP-9. There were significant elevations in serum levels of AFP. HGF and plasma levels of MMP-9 in patients with HCC compared to other studied groups. Also serum AFP and HGF levels in group II and III were higher than those of the controls. However, MMP-9 levels in group II and III were not significantly different from those of the controls. Also MMP-9 and HGF levels were significantly higher in HCC patients with lung metastasis. portal invasion and tumour size = 2cm. MMP-9 showed a positive correlation with HGF in HCC group, but no correlations were found between AFP and either MMP-9 or HGF. The sensitivity and specificity of MMP-9 in detection of HCC were 100%. So we can conclude that, plasma MMP-9 might be a candidate for a sensitive marker for HCC, particularly for metastatic potential. HGF may be responsible for activation of MMP-9 production in HCCs
Sujets)
Humains , Mâle , Femelle , Matrix metalloproteinase 9 , Facteur de croissance des hépatocytes , Alphafoetoprotéines , Sensibilité et spécificité , Abdomen/imagerie diagnostique , Marqueurs biologiques tumorauxRésumé
Little is know about the colonic mucosal changess in patients with portal hypertension. The present study was carried out in order to assess the prevalence and factors influencing colonic mucosal changes in patients with liver cirrhosis. This study was carried out on 40 patients with liver cirrhosis and portal hypertension, divided into 2 groups, A and B, 20 patients for each group, and 10 control subjects. Patients of group B had a history of haematemesis and / or melaena and underwent regular injection sclerotherapy for oesophageal varices. Full-length colonoscopy was carried out in all cases with mucosal biopsy for histopathology. The results of this study showed that, colopathy was found in 75% of patients of group A and in 75% of patients of group B. Anorectal varices were found in 35% of patients of group A and in 40% of patients of group B, and colonic varices in 40% of group A and in 45% of group B. Portal colopathy occurs more commonly in cirrhotic patients with gastric varices, while neither oesophageal varices nor its sclerotherapy have significant relation to the development of colopathy. Portal colopathy have no significant relation to the severity of the underlying liver disease, while it have a significant relation to the presence of ocult blood in stool in patients suffering from anaemia without history of gastrointestinal bleeding. It is concluded that, colonic mucosal vascular changes in patients with liver cirrhosis is significantly high and these changes are a likely source of lower gastrointestinal bleeding