الفهرس 
List of ContentsOnly 14 pages are availabe for public view
 |  | from | 140 |  |  |
| | | from | 140 | | |
Abstract
Summary : Hepatocellular carcinoma (HCC) is the second-most common and fastest rising cause of cancer-related death. In Egypt, HCC constitutes a significant public health problem. HCC is responsible for 33.63 % and 13.54% of all cancers in Egyptian males and females, respectively. chronic hepatitis C virus (HCV) infection is a leading cause of HCC. The overall prevalence of HCV among Egyptian HCC cases is nearly 84%. Direct acting antivirals (DAA) have recently been developed to treat patients with hepatitis C virus (HCV) infection, and interferon-free DAA treatment has improved the cure rate of patients. However, the occurrence rate of hepatocellular carcinoma (HCC) following HCV eradication remains unknown. Early prediction of development of HCC is a matter of great importance to decrease the burden of the disease and early manage the associated complications. The aim of this study is to evaluate the role of APRI as a predictor of HCC development among HCV cirrhotic patients after successful antiviral therapy with directly-acting antiviral drugs. This study included 50 patients with HCV who were treated with DAAs. There were 2 protocols of treatment; one of them is 2 drugs regimen which entails the receipt of Sofsobuvir + Daclatasvir for 24weeks and the 3 drugs regimen where Sofsobuvir + Daclatasvir + ribavirin was received for 12 weeks. After approval from the institutional review board of Mansoura Faculty of Medicine, the medical records of the study cases were revised for full history, items of clinical examination and laboratory investigation. Data from abdominal ultrasonography was also recorded. Calculation of Aspartate Aminotransferase to Platelet Ratio Index was performed before and after treatement and initial values were compared between the cases who developed and who didn’t develop HCC. The results of this study showed that : 1. The mean age of the cases in the study is 54.17 ± 5.37 years with range between 41 and 70 years, there were 27 males (54%) and 23 females (46%). 2. There was a statistically significant decrease in the mean hemoglobin concentration, ALT, AST, alkaline phosphatase, INR, total bilirubin and AFP after treatment as compared with before treatment values. 3. Mean platelets count significantly increased after treatment. 4. Serum creatinine and direct bilirubin levels didn’t reveal a significant change after treatment as compared with pretreatment value. 5. All the cases had PCR level below detection after treatment. 6. There was a statistically significant decrease in the mean APRI after treatment as compred with the before treatment value. 7. The incidence of development of HCC after 1 year follow up among the cases included in the study was 14%. 8. There was no statistically significant difference in the maen age, sex distribution and treatment regiemen between the cases who developed and who didn’t develop HCC. 9. The APRI score in the cases who developed HCC was statistically significanly higher in the cases who developed HCC. 10. The best cutoff point of APRI score to predict the development of HCC was occurrence of mortality was > 0.695 with 96.4% sensitivity, 56.2% specificity.