Distribution of P53 and mdm2 genes in patients with hepatocellular carcinoma

50 patients with hepatocellular carcinoma, 36 males and 14 females 14-73 years old were studied in this work. Abnormal values of s.. bilirubin. AST, ALT and alkaline phosphatase were found in 52, 64 and 76% of cases respectively. 70%of cases had AFP levels between 50 and 150ng/dl while 6/had levels below 10ng/dl. 46.had stage 1:36 stage II and 18/had stage III disease. P53 was overexpressed in 46% of cases not related to age or sex. A statistically significant relationship was found between mdm2 overexpression and the stage of the tumor. 42% of cases were P53 positive and mdm2 negative and 24% of cases were P53 negative and mdm2 positive that may indicate that mdm2 overexpression and P53 mutation represent alternative mechanisms for inactivating the same regulatory pathway for suppressing cell growth. Concomitant overexpression of either P53 or mdm2 or both was found to have statistically significant relation with tumour stage indicating that P53 mutation and mdm2 overexpression are alternative mechanisms for inactivating the same pathway for suppressing cell growth. It can be concluded that P53 in activation may be involved in the molecular pathogenesis of HCC and its mutation is late in HCC and its frequency is related to tumour progression mdm2 overexpression has the same significance. Tumors with mdm2 overexpression were devoid of P53 mutations and vice verca; indicating that they represent alternative mechanisms for inactivating the same regulatory pathway for suppressing cell growth

Clinical and ultrasonographic prediction of Oesophageal varices in liver cirrhosis

Since bleeding from oesophageal varices is a major complication of chronic liver diseases among Egyptians, early diagnosis of portal hypertension and varices may prevent and control bleeding. 139 patients with chronic liver disease of different grades were classified and investigated. 89 with no varices, 27 with small and 23 with large varices. Clinical examination, liver functions, blood picture, hepatitis markers, rectal snips for bilharzial ova, upper gastrointestinal endoscopy and abdominal ultrasonography with Doppler study of portal vein, splenic vein and hepatic artery were done for every patient. The results showed significant relation between presence of oesophageal varices and hepatic coma, spider navi, ascites and increased score of child classification. There was significant positive relation between splenic size and negative relation of liver size and presence or grading of varices. A significant positive relation was found between presence of varices and post hepatitic cirrhosis. A significant increase in total bilirubin, AST, ALT, ALKphos., and decrease in serum albumin and prothlrombin concentration in patients with varices as well as a significant decrease in R.B.Cs, W.B.Cs, Platelets and HP% in the group with varices. Doppler study revealed increase in P. V.D, P. V.C.A, and decrease in P. V.C.I and P. V.M. V in patients with varices. Doppler study on hepatic artery showed good correlation of H .A. P.I, L V.I but not H.A.M. V and the presence of varices. No parameter was found to differentiate small from large varices except splenic size and ascites. This leads to the conclusion that clinical, ultrasonic and Doppler examinations of hepatic patients may suggest the presence of varices without, need for endoscopic examination of every patient