Page 276 - ebook HCC

PROGRAMME
EASL
GENEV
274 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEVA, SWITZERLANDA, SWITZERLAND EASL HCC SUMMITHCC SUMMIT 275
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FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C50 Poster Board Number C51
MICRO RNA SIGNATURE IN EGYPTIAN HEPATOCELLULAR CARCINOMA IN POST VIRAL
PATIENTS WITH CHRONIC HEPATITIS C HEPATITIS CIRRHOTIC PATIENTS: A STUDY
RELATED HEPATOCELLULAR CARCINOMA FROM PAKISTAN

Heba Omar and El-Garem H., Shehab H., Al-Akel W., Amer A., Shaker O. Muhammad Asad , Umair Arif , Muhammad R. Hafeez 1
1
1
1 Department of Medicine, Quaid-e-Azam Medical College/Bahawal Victoria Hospital,
Corresponding author’s e-mail: hebaomar1202@hotmail.com Bahawalpur. Pakistan, Bahawalpur, Pakistan
Corresponding author’s e-mail: docasadk@gmail.com
Introduction: MicroRNA (miRNA) is a small noncoding RNA gene product known to
post-transcriptionally modulate gene expression by negatively regulating the stability of Introduction: Cirrhosis secondary to viral hepatitis is a common disease in the developing
its target mRNAs. Several miRNAs were found to be potential diagnostic, prognostic, or countries. With the advancement in the treatment of complications of cirrhosis and decrease
metastatic markers for hepatocellular carcinoma (HCC). in the mortality, more patients are noe presenting with hepatocellular carcinoma (HCC).
Aims: There is increased incidence of HCC in cirrhotic patients. Studies are lacking in
Aims: Evaluation of serum miRNA-122 and miRNA-221expression that can represent a this part of world. We carried out this study to have an insight into the magnitude of this
possible non-invasive signature for early diagnosis of HCC among patients HCV-chronic problem, to identify the common presentations of HCC and to devise a roadmap to the
liver disease. early diagnosis of such patients with our limited resources.
Methodology: This prospective study was conducted on 90 adult patients of both sex with Methodology: It is a prospective analytical study carried out at Bahawal Victoria Hospital,
HCV-related chronic liver disease and chronic hepatitis C related HCC. In addition to 10 Bahawalpur. Pakistan from January 2011 to January 2013. Only the patients with
healthy control individuals, patients were stratified into; interferon-naïve chronic hepatitis C documented cirrhosis were included in this study. The patients were diagnosed on the
basis of hepatitis B, C and D polymerase chain reaction. The serum alpha fetoprotein
(CH) (n=30), post-hepatitis C compensated cirrhosis (n=30) and treatment-naïve HCC (n=30). (AFP) was measured and the ascitic fluid analysis was done. The liver imaging was done
All patients and controls have undergone full clinical assessment and lab investigations in by ultrasonography and computed tomography scan. The data was analyzed with the help
addition to the evaluation of the level of serum miRNA expression by RT-PCR. of SPSS version 10. A p-value of <0.05 was considered significant.
An informed written consent was taken from all participants in addition to an institutional
ethical committee approval. Results: A total of 87 patients who developed hepatocellular carcinoma (HCC) were included
CLINICAL POSTER ABSTRACTS patients (chronic HCV and liver cirrhosis groups). co infection 9.19% (n=8). Thus, Hepatitis C was found in 79.31% whereas Hepatitis B in 58%. CLINICAL POSTER ABSTRACTS
in this study. Out of them, Hepatitis B group included 12.64% (n=11), Hepatitis C 33.33% (n=29),
The ROC curves were performed to determine the best cutoff, sensitivity and specificity
Hepatitis B/C co infection 36.78% (n=32), Hepatitis B/D 8.05% (n=7) and the Hepatitis B/D/C
values for the candidate markers that could differentiate HCC patients from non HCC
58.62% (n=51) had ascites, 60.78% (n=31) of whom demonstrated hemorrhagic ascites,
with 87.09% (n=27) patients showing malignant cells on microscopic examination
of ascitic fluid. Spontaneous bacterial peritonitis was confirmed in 33.33% (n=17).
Results: The median level of miRNA-221 expression (0.92) was significantly down-
AFP was raised in 94.25% (n=82). 26.82% (n=22) had AFP levels more
regulated in HCC patients compared to non-HCC patients (1.81) (p value 0.03).In
than four times the upper limit of normal (xULN), 69.51% (n=57) had
contrast, median level of miRNA-122 expression showed non-significant up-regulation in
HCC patients (p value 0.21). At a cutoff 1.82, miRNA-221 yielded 87% sensitivity and
On imaging, unifocal lesion was seen in 90.80% (n=79), whereas 9.20% (n=8) showed
40% specificity in differentiating HCC patients from non-HCC patients (chronic HCV and AFP lmore than 3xULN and 9.75% (n=8) had values more than 2Xuln.
multifocal lesions. 50.77% (n=52) had lesions >3 cm compared with 40.22% (n=35) who
liver cirrhosis groups) as shown in figure (1). Both miRNA-221 and miRNA-122 were not had lesions <3 cm.
significantly related to the characteristic of hepatic focal lesion (size, number, site)
Conclusion: HCC is a late complication of cirrhosis. Investigations as simple as ascitic
Conclusion: MiRNA-221 expression could represents a potential non- invasive diagnostic fluid examination and ultrasonography of abdomen may aid tremendously in diagnosing
marker for early detection of HCC this disease.