Significance of Serum Cytokeratin-18 in Prediction of Hepatocellular Carcinoma in Chronic Hepatitis C Infected Egyptian Patients.
BACKGROUND
Hepatitis C virus is one of the most common etiologic agents of chronic liver diseases, including liver cirrhosis and hepatocellular carcinoma in which there is continuous inflammation and regeneration of hepatocytes. Cytokeratin-18 (CK18) has been suggested to play an important role in tumorigenesis of epithelial cancers.


OBJECTIVE
Estimation of CK18 serum levels in patients with chronic viral hepatitis C (CHCV) and hepatocellular carcinoma (HCC) and find the relationship between their levels, the severity of the disease and the development of HCC.


METHODS
We measured serum levels of CK18 in 60 Egyptian patients (30 with CHCV & 30 with HCC) and 30 healthy controls.


RESULTS
Patients with HCC had highly significant increased CK18 levels compared with CHCV patients, healthy controls. Cytokeratin-18 among the three classes of Child-Pugh classification show highly significant gradual increase from child A to C. Furthermore, In HCC there were positive correlations between CK18 and with RBCs, ESR, and AFP.


CONCLUSIONS
CK18 is a sensitive indicator of the severity of liver disease. Patients with CHCV infection can be followed up by measurement of its serum level which can predict the development of HCC. The combination of AFP and CK18 increased the sensitivity of detection for HCC.
Faculty of Medicine for Girls Al-Azhar University, Tropical Medicine, Cairo, Egypt.
Wafaa
W
El-Zefzafy
Faculty of Medicine for Girls Al-Azhar University, Internal Medicine, Cairo, Egypt.
Hanan
H
Eltokhy
Department of Clinical and Chemical Pathology, National Research Center, AL-Tahreer Street, AL-Dokki, Giza, Cairo 12622, Egypt.
Nagwa Abd El-Ghaffar
NA
Mohamed
Faculty of Medicine for Girls Al-Azhar University, Clinical Pathology, Cairo, Egypt.
Zakia
Z
Abu-Zahab
Cytokeratin-18; HCC; tumor marker; viral hepatitis; α-fetoprotein