1
|
Omar A, Kaseb A, Elbaz T, El-Kassas M, El Fouly A, Hanno AF, El Dorry A, Hosni A, Helmy A, Saad AS, Alolayan A, Eysa BE, Hamada E, Azim H, Khattab H, Elghazaly H, Tawfik H, Ayoub H, Khaled H, Saadeldin I, Waked I, Barakat EMF, El Meteini M, Hamed Shaaban M, EzzElarab M, Fathy M, Shaker M, Sobhi M, Shaker MK, ElGharib M, Abdullah M, Mokhtar M, Elshazli M, Heikal OMK, Hetta O, ElWakil RM, Abdel Wahab S, Eid SS, Rostom Y. Egyptian Society of Liver Cancer Recommendation Guidelines for the Management of Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:1547-1571. [PMID: 37744303 PMCID: PMC10516190 DOI: 10.2147/jhc.s404424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023] Open
Abstract
Globally, hepatocellular carcinoma (HCC) is the fourth most common cause of death from cancer. The prevalence of this pathology, which has been on the rise in the last 30 years, has been predicted to continue increasing. HCC is the most common cause of cancer-related morbidity and mortality in Egypt and is also the most common cancer in males. Chronic liver diseases, including chronic hepatitis C, which is a primary health concern in Egypt, are considered major risk factors for HCC. However, HCC surveillance is recommended for patients with chronic hepatitis B virus (HBV) and liver cirrhosis; those above 40 with HBV but without cirrhosis; individuals with hepatitis D co-infection or a family history of HCC; and Nonalcoholic fatty liver disease (NAFLD) patients exhibiting significant fibrosis or cirrhosis. Several international guidelines aid physicians in the management of HCC. However, the availability and cost of diagnostic modalities and treatment options vary from one country to another. Therefore, the current guidelines aim to standardize the management of HCC in Egypt. The recommendations presented in this report represent the current management strategy at HCC treatment centers in Egypt. Recommendations were developed by an expert panel consisting of hepatologists, oncologists, gastroenterologists, surgeons, pathologists, and radiologists working under the umbrella of the Egyptian Society of Liver Cancer. The recommendations, which are based on the currently available local diagnostic aids and treatments in the country, include recommendations for future prospects.
Collapse
Affiliation(s)
- Ashraf Omar
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Kaseb
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tamer Elbaz
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed El-Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Amr El Fouly
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Abdel Fatah Hanno
- Department of Gastroenterology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed El Dorry
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Hosni
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Amr Helmy
- Department of Surgery, National Liver Institute Menoufia University, Menoufia, Egypt
| | - Amr S Saad
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ashwaq Alolayan
- Department of Oncology, National Guard Hospital, Riyadh, Saudi Arabia
| | - Basem Elsayed Eysa
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Emad Hamada
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hamdy Azim
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany Khattab
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hesham Elghazaly
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hesham Tawfik
- Department of Oncology, Faculty of Medicine, Tanta University, TantaEgypt
| | - Hisham Ayoub
- Department of Gastroenterology, Military Medical Academy, Cairo, Egypt
| | - Hussein Khaled
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ibtessam Saadeldin
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Imam Waked
- Department of Gastroenterology, Menoufia Liver Institute, Menoufia, Egypt
| | - Eman M F Barakat
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud El Meteini
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Hamed Shaaban
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed EzzElarab
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mohamed Fathy
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Shaker
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Sobhi
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Kamal Shaker
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed ElGharib
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohammed Abdullah
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohesn Mokhtar
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mostafa Elshazli
- Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Osama Hetta
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Reda Mahmoud ElWakil
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sameh Abdel Wahab
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samir Shehata Eid
- Department of Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Yousri Rostom
- Department of Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - On behalf of the Egyptian Liver Cancer Committee Study Group
- Department of Gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Gastrointestinal Medical Oncology, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt
- Department of Gastroenterology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
- Department of Interventional Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Interventional Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Surgery, National Liver Institute Menoufia University, Menoufia, Egypt
- Department of Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Oncology, National Guard Hospital, Riyadh, Saudi Arabia
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Tanta University, TantaEgypt
- Department of Gastroenterology, Military Medical Academy, Cairo, Egypt
- Department of Gastroenterology, Menoufia Liver Institute, Menoufia, Egypt
- Department of Gastroenterology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Oncology, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Oncology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| |
Collapse
|
2
|
Azzam A, Khaled H, Elbohy OA, Mohamed SA, Mohamed SMH, Abdelkader AH, Ezzat AA, Elmowafy AOI, El-Emam OA, Awadalla M, Refaey N, Rizk SMA. Seroprevalence of hepatitis B virus surface antigen (HBsAg) in Egypt (2000-2022): a systematic review with meta-analysis. BMC Infect Dis 2023; 23:151. [PMID: 36899311 PMCID: PMC10007808 DOI: 10.1186/s12879-023-08110-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Hepatitis B infection seriously threatens global public health, especially in developing nations. Despite several investigations on HBV incidence, the national pooled prevalence remains unknown, particularly in populations at-risk at whom interventions should be primarily aimed. METHODS A comprehensive literature search of the following databases: Medline [PubMed], Scopus, Google Scholar, and Web of Science was conducted following the PRISMA guidelines. I-squared and Cochran's Q were used to measure the heterogeneity between the studies. Publications that matched the following were included: Primary studies published in Egypt from 2000 to 2022 reported HBV prevalence based on HBsAg. We excluded any studies that were not performed on Egyptians or that were performed on patients suspected of acute viral hepatitis or studies focusing on occult hepatitis or vaccination evaluation studies, or national surveys. RESULTS The systematic review included 68 eligible studies reporting a total of 82 incidences of HBV infection based on hepatitis B surface antigen with a total sample size of 862,037. The pooled national prevalence among studies was estimated to be 3.67% [95% CI; 3: 4.39]. Children under 20 with a history of HBV vaccination during infancy had the lowest prevalence of 0.69%. The pooled prevalence of HBV infection among pregnant women, blood donors, and healthcare workers was 2.95%, 1.8%, and 1.1%, respectively. While patients with hemolytic anemia and hemodialysis patients, patients with malignancies, HCC patients, and chronic liver disease patients had the highest prevalences at 6.34%, 25.5%, 18.6%, and 34%, respectively. Studies reporting HBV prevalence in urban settings compared to rural settings revealed a similar HBV prevalence of 2.43% and 2.15%, respectively. Studies comparing HBV prevalence in males and females revealed a higher prevalence among males (3.75%) than females (2.2%). CONCLUSION In Egypt, hepatitis B infection is a significant public health issue. The blocking of mother-to-infant hepatitis B transmission, the scaling up of the scope of the existing vaccination program, and implementing new strategies, including screen-and-treat, may reduce the prevalence of the disease.
Collapse
Affiliation(s)
- Ahmed Azzam
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Ain Helwan, Cairo, Egypt.
| | - Heba Khaled
- Department of Biochemistry, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Ola A Elbohy
- Department of Virology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | | | | | - Ahmed H Abdelkader
- Department of Microbiology Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt
| | | | | | - Ola Ali El-Emam
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mona Awadalla
- Department of Oral Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Neveen Refaey
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | | |
Collapse
|
3
|
Youssef DM, El-Shal AS, Elbehidy RM, Fouda MA, Shalaby SM, El Hawy LL, Elsadek AF, Neemat-Allah MAA, Ramadan SM, Gohary A, Arab F, Alsharkawy M, Tolba SAR, Abdelsalam MM, Amin EK, Gehad MH. Hepatitis B Immunization Status in Children with Chronic Kidney Disease: Experience at a Single Center, Egypt. J Clin Med 2023; 12:jcm12051864. [PMID: 36902652 PMCID: PMC10003117 DOI: 10.3390/jcm12051864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 03/03/2023] Open
Abstract
Background: Children with chronic kidney disease (CKD), particularly those who require hemodialysis (HD), are at high risk of hepatitis B virus (HBV) infection. The HBV vaccine non-/hypo-response rate among HD children remains high, and it is critical to investigate the influencing factors and their linkages. The aim of this study was to identify the pattern of HB vaccination response in HD children and to analyze the interference of various clinical and biomedical factors with the immunological response to HB vaccination. Methods: This cross-sectional study included 74 children on maintenance hemodialysis, aged between 3 and 18 years. These children were subjected to complete clinical examination and laboratory investigations. Results: Out of a total of 74 children with HD, 25 (33.8%) were positive for the HCV antibody. Regarding the immunological response to hepatitis B vaccine, 70% were non-/hypo-responders (≤100 IU/mL) and only 30% mounted a high-level response (more than 100 IU/mL). There was a significant relation between non-/hypo-response and sex, dialysis duration, and HCV infection. Being on dialysis for more than 5 years and being HCV Ab-positive were independent variables for non-/hypo-response to HB vaccine. Conclusions: Children with CKD on regular HD have poor seroconversion rates in response to the HBV vaccine, which were influenced by dialysis duration and HCV infection.
Collapse
Affiliation(s)
- Doaa Mohammed Youssef
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Amal S. El-Shal
- Medical Biochemistry Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
- Medical Biochemistry and Molecular Biology Department, Armed Forces College of Medicine (AFCM), Cairo 11774, Egypt
- Correspondence: or ; Tel.: +20-1221546634
| | - Rabab M. Elbehidy
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Mohamed Adel Fouda
- Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Sally M. Shalaby
- Medical Biochemistry Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Lamiaa Lotfy El Hawy
- Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | | | | | - Seham M. Ramadan
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Amal Gohary
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Faika Arab
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Mona Alsharkawy
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | | | | | - Ezzat Kamel Amin
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Mona Hamed Gehad
- Pediatrics Department, Faculty of Human Medicine, Zagazig University, Zagazig 44519, Egypt
| |
Collapse
|
4
|
A fractional-order model of human liver: Analytic-approximate and numerical solutions comparing with clinical data. ALEXANDRIA ENGINEERING JOURNAL 2021. [DOI: 10.1016/j.aej.2021.03.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
5
|
Bévant K, Desoteux M, Abdel Wahab AHA, Abdel Wahab SA, Metwally AM, Coulouarn C. DNA Methylation of TGFβ Target Genes: Epigenetic Control of TGFβ Functional Duality in Liver Cancer. Cells 2021; 10:2207. [PMID: 34571856 PMCID: PMC8468746 DOI: 10.3390/cells10092207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022] Open
Abstract
Transforming growth factor beta (TGFβ) plays a key role in liver carcinogenesis. However, its action is complex, since TGFβ exhibits tumor-suppressive or oncogenic properties, depending on the tumor stage. At an early stage TGFβ exhibits cytostatic features, but at a later stage it promotes cell growth and metastasis, as a potent inducer of epithelial to mesenchymal transition (EMT). Here, we evaluated DNA methylation as a possible molecular mechanism switching TGFβ activity toward tumor progression in hepatocellular carcinoma (HCC). We report that decitabine, a demethylating agent already used in the clinic for the treatment of several cancers, greatly impairs the transcriptional response of SNU449 HCC cells to TGFβ. Importantly, decitabine was shown to induce the expression of EMT-related transcription factors (e.g., SNAI1/2, ZEB1/2). We also report that the promoter of SNAI1 was hypomethylated in poor-prognosis human HCC, i.e., associated with high grade, high AFP level, metastasis and recurrence. Altogether, the data highlight an epigenetic control of several effectors of the TGFβ pathway in human HCC possibly involved in switching its action toward EMT and tumor progression. Thus, we conclude that epidrugs should be carefully evaluated for the treatment of HCC, as they may activate tumor promoting pathways.
Collapse
Affiliation(s)
- Kevin Bévant
- Centre de Lutte Contre le Cancer Eugène Marquis, Inserm, University of Rennes 1, UMR_S 1242, COSS (Chemistry, Oncogenesis Stress Signaling), 35042 Rennes, France; (K.B.); (M.D.)
| | - Matthis Desoteux
- Centre de Lutte Contre le Cancer Eugène Marquis, Inserm, University of Rennes 1, UMR_S 1242, COSS (Chemistry, Oncogenesis Stress Signaling), 35042 Rennes, France; (K.B.); (M.D.)
| | | | - Sabrin A. Abdel Wahab
- Medical Laboratory Department, Students Hospital, Cairo University, Cairo 11796, Egypt;
| | - Ayman Mohamed Metwally
- Medical Laboratory Technology Department, College of Applied Health Science Technology, Misr University for Science and Technology (MUST), Al-Motamayez District, 6th of October P.O. Box 77, Egypt
| | - Cédric Coulouarn
- Centre de Lutte Contre le Cancer Eugène Marquis, Inserm, University of Rennes 1, UMR_S 1242, COSS (Chemistry, Oncogenesis Stress Signaling), 35042 Rennes, France; (K.B.); (M.D.)
| |
Collapse
|
6
|
Elbahrawy A, Ibrahim MK, Eliwa A, Alboraie M, Madian A, Aly HH. Current situation of viral hepatitis in Egypt. Microbiol Immunol 2021; 65:352-372. [PMID: 33990999 DOI: 10.1111/1348-0421.12916] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/02/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022]
Abstract
An estimated 8-10 million people suffer from viral hepatitis in Egypt. Hepatitis A virus (HAV) and hepatitis E virus (HEV) are the major causes of viral hepatitis in Egypt as 50% or more of the Egyptian population are already exposed to HAV infection by the age of 15. In addition, over 60% of the Egyptian population test seropositive for anti-HEV in the first decade of life. HEV mainly causes self-limiting hepatitis; however, cases of fulminant hepatitis and liver failure were reported in Egypt. Hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis D virus (HDV) are the main causes of chronic hepatitis, liver cirrhosis, and liver cancer (hepatocellular carcinoma [HCC]) in Egypt. Globally, Egypt had the highest age-standardized death rate due to cirrhosis from 1990 to 2017. The prevalence rate of HBV (1.3%-1.5%) has declined after national infantile immunization. Coinfection of HBV patients with HDV is common in Egypt because HDV antibodies (IgG) vary in range from 8.3% to 43% among total HBV patients. After the conduction of multiple national programs to control HCV infection, a lower rate of HCV prevalence (4.6%) was recently reported. Data about the incidence of HCV after treatment with direct antiviral agents (DAAs) are lacking. An HCC incidence of 29/1000/year in cirrhotic patients after DAA treatment is reported. A higher rate of infiltrative pattern among HCC patients after DAA treatment is also recognized. Viral hepatitis is one of the major public health concerns in Egypt that needs more attention and funding from health policymakers.
Collapse
Affiliation(s)
- Ashraf Elbahrawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Marwa K Ibrahim
- Department of Microbial Biotechnology, Division of Genetic Engineering and Biotechnology Research, National Research Centre, Giza, Egypt.,Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ahmed Eliwa
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ali Madian
- Department of Internal Medicine, Al-Azhar University, Assiut, Egypt
| | - Hussein Hassan Aly
- Department of Virology II, National Institute of Infectious Diseases, Tokyo, Japan
| |
Collapse
|
7
|
Abulkhair HS, Turky A, Ghiaty A, Ahmed HE, Bayoumi AH. Novel triazolophthalazine-hydrazone hybrids as potential PCAF inhibitors: Design, synthesis, in vitro anticancer evaluation, apoptosis, and molecular docking studies. Bioorg Chem 2020; 100:103899. [DOI: 10.1016/j.bioorg.2020.103899] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023]
|
8
|
El Fayoumie M, Abdelhady M, Gawish A, Hantour U, Abdelkhaleek I, Abdelraheem M, Alsawak A, Alwassief A, Elbahrawy A. Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents. Gastrointest Tumors 2020; 7:50-60. [PMID: 32399465 DOI: 10.1159/000505326] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/07/2019] [Indexed: 12/13/2022] Open
Abstract
Introduction The impact of direct antiviral agents (DAAs) on the development of hepatocellular carcinoma (HCC) is controversial. One important aspect of this controversy is the changing pattern of HCC. Objective In this study, we attempted to assess the changes in the pattern of HCC after treatment with DAAs. Methods A total of 51 HCC patients after DAA treatment and 54 HCC patients without DAA treatment were included. The diagnosis of HCC was based on typical dynamic CT and/or MRI criteria in both groups. Liver status was assessed by means of the fibrosis 4 index (Fib-4), Child-Pugh classification, and model for end-stage liver disease (MELD). HCC infiltrative pattern, portal vein thrombosis (PVT), local and distant metastases, and α-fetoprotein (AFP) level were compared in the 2 groups. The staging of HCC and treatment decisions were made in both groups following the Milan criteria, Barcelona Clinic Liver Cancer staging, tumor-node-metastasis staging, and Cancer of the Liver Italian Program categorization. Results The mean age of the HCC patients after DAA treatment (59.1± 7.4 years) was older than that of the HCC patients without DAA treatment. There was no significant difference between groups regarding sex distribution. The mean Fib-4 score (4.84 ± 3.53) was significantly lower in HCC patients after DAA treatment than in those without DAA treatment. The frequency of the infiltrative HCC pattern, PVT, and regional lymph node metastasis was significantly higher in HCC patients after DAA treatment than in those without DAA treatment (p ≤ 0.05); mean AFP level (5,085.2 ± 11,883.2 ng/mL) was also significantly higher. HCC patients after DAA treatment had significantly advanced stages and limited treatment options (p ≤ 0.05). Conclusion The changing HCC pattern after DAA treatment may suggest the need for new HCC staging and treatment protocols.
Collapse
Affiliation(s)
| | | | - Ahmed Gawish
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Usama Hantour
- Department of Tropical Medicine, Al-Azhar University, Cairo, Egypt
| | | | | | - Alaa Alsawak
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Alwassief
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ashraf Elbahrawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| |
Collapse
|
9
|
Rashed WM, Kandeil MAM, Mahmoud MO, Ezzat S. Hepatocellular Carcinoma (HCC) in Egypt: A comprehensive overview. J Egypt Natl Canc Inst 2020; 32:5. [PMID: 32372179 DOI: 10.1186/s43046-020-0016-x] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/02/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Worldwide, hepatocellular carcinoma (HCC) is a universal problem and its epidemiological data showed variation from place to place. Hepatocellular carcinoma (HCC) is the sixth and fourth common cancer in worldwide and Egypt, respectively. Egypt ranks the third and 15th most populous country in Africa and worldwide, respectively. The aim of this review is to compare the status of HCC in Egypt to that in the worldwide from different issues; risk factors, screening and surveillance, diagnosis and treatment, prevention, as well as research strategy. MAIN BODY The risk factors for HCC in Egypt are of great importance to be reported. The risk factor for HCC are either environmental- or host/genetic-related risk factors. In the last years, there is a tangible improvement of both screening and surveillance strategies of HCC in Egypt. The unprecedented national screening campaign launched by the end of 2018 is a mirror image of this improvement. While the improvement of the HCC prevention requires the governmental health administration to implement health policies. Although the diagnosis of Egyptian HCC patients follows the international guidelines but HCC treatment options are limited in terms of cost. In addition, there are limited Egyptian reports about HCC survival and relapse. Both basic and clinical HCC research in Egypt are still limited compared to worldwide. SHORT CONCLUSION Deep analysis and understanding of factors affecting HCC burden variation worldwide help in customization of efforts exerted to face HCC in different countries especially large country like Egypt. Overall, the presence of a research strategy to fight HCC in Egyptian patients will help in the optimum allocation of available resources to reduce the numbers of HCC cases and deaths and to improve the quality of life.
Collapse
Affiliation(s)
- Wafaa M Rashed
- Department of Research, Children's Cancer Hospital-57357, Cairo, Egypt.
| | | | - Mohamed O Mahmoud
- Department of Biochemistry, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Sameera Ezzat
- Department of Epidemiology and Prevention Medicine, National Liver Institute, Menoufia University, Menoufia, Egypt
| |
Collapse
|
10
|
Alboraie M, Youssef N, Sherief AF, Afify S, Wifi MN, Omran D, Hafez E, Omar H, Eltabbakh M, Abdellah M, El Badry M, Salaheldin M, Ahmed Y, Ali-Eldin Z, Farid A, Abdeen N, El Halwagy H, Abdalgaber M, Moaz I, Ezzat S, El Kassas M. Egyptian liver library: An indexed database for liver disease evidence in Egypt. Arab J Gastroenterol 2019; 20:109-113. [PMID: 31175077 DOI: 10.1016/j.ajg.2019.05.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/27/2019] [Accepted: 05/25/2019] [Indexed: 12/20/2022]
|
11
|
Abd El Moety HA, Maharem DA, Gomaa SH. Serotonin: is it a marker for the diagnosis of hepatocellular carcinoma in cirrhotic patients? ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2013.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Hoda Aly Abd El Moety
- Chemical Pathology, Medical Research Institute , Alexandria University , 16 Alexander the Great , Azarita, Alexandria, Egypt
| | - Dalia Aly Maharem
- Internal Medicine, Medical Research Institute , Alexandria University , 16 Alexander the Great , Azarita, Alexandria, Egypt
| | - Salwa Hamdy Gomaa
- Chemical Pathology, Medical Research Institute , Alexandria University , 16 Alexander the Great , Azarita, Alexandria, Egypt
| |
Collapse
|
12
|
The association between vitamin D receptor gene polymorphisms and hepato-cellular carcinoma in Egyptian patients with chronic liver disease. GENE REPORTS 2018. [DOI: 10.1016/j.genrep.2018.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
13
|
Hany H, Shalaby A, Al Kashef W, Kandil W, Shahin RA, El-Alfy H, Besheer T, Farag R, Mohamed M. Evaluation of the role of Notch1 expression in hepatic carcinogenesis with clinico-pathological correlation. Pathology 2018; 50:730-736. [PMID: 30389219 DOI: 10.1016/j.pathol.2018.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/14/2018] [Accepted: 08/22/2018] [Indexed: 02/07/2023]
Abstract
The role of Notch pathway in hepatocarcinogenesis is unclear with conflicting results reported from different researchers. This study aimed to investigate the exact role of Notch1 in hepatocarcinogenesis and its influence on survival and to determine the possibility of it being a target therapy. Differential immunohistochemical expression of Notch1 in 100 cases of hepatocellular carcinoma (HCC) and adjacent non-neoplastic liver tissue was performed. The results showed that expression of Notch1 was significantly higher in the non-neoplastic hepatic tissues than in HCC tissues (p < 0.001), but there was no significant difference in Notch1 expression between cirrhotic and non-cirrhotic liver tissue (p = 0.197). Notch1 expression was higher in low grade than in high grade HCC (p = 0.036). Notch1 expression showed reverse correlation with mitotic count (p = 0.008), and necrosis (p = 0.005). The disease free survival was shorter in patients displaying low levels of Notch1 expression (p = 0.045). The overall survival showed no significant difference between high and low levels of Notch1 expression; however, it was somewhat longer in patients with high Notch1 expression (p = 0.220). In conclusion, the tumour suppressor role of Notch1 was supported and the use of Notch1 agonists may have a role in improving the prognosis of HCC.
Collapse
Affiliation(s)
- Heba Hany
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Asem Shalaby
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt; Pathology Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | - Wagdi Al Kashef
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Wageha Kandil
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Rehab-Allah Shahin
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt
| | - Hatem El-Alfy
- Tropical Disease Department, Mansoura University Hospital, Mansoura University, Mansoura, Egypt
| | - Tarek Besheer
- Tropical Disease Department, Mansoura University Hospital, Mansoura University, Mansoura, Egypt
| | - Raghda Farag
- Tropical Disease Department, Mansoura University Hospital, Mansoura University, Mansoura, Egypt
| | - Mie Mohamed
- Pathology Department, College of Medicine, Mansoura University, Mansoura, Egypt
| |
Collapse
|
14
|
Raad II, Chaftari AM, Torres HA, Ayoub EM, Narouz LI, Bartek J, Hachem R. Challenge of hepatitis C in Egypt and hepatitis B in Mauritania. World J Hepatol 2018; 10:549-557. [PMID: 30310533 PMCID: PMC6177572 DOI: 10.4254/wjh.v10.i9.549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/14/2018] [Accepted: 05/30/2018] [Indexed: 02/06/2023] Open
Abstract
Egypt has one of the highest prevalence rates of hepatitis C virus (HCV) in the world, mostly with genotype 4 that is highly associated with severe fibrosis. As a consequence, hepatocellular carcinoma has become the leading cause of cancer in this country. Mauritania is a highly endemic area for hepatitis B virus (HBV). HBV and HCV could both be iatrogenically transmitted through infected blood products, infected needles, and medical equipment improperly sterilized. Adequate and efficient healthcare and public health measures with good surveillance programs, access for screening, prevention strategies, and successful treatment are needed to halt the spread of these diseases. Herein, we have reviewed the epidemiology, modes of transmission, predisposing factors, and novel treatment modalities of these viruses. We have proposed practices and interventions to decrease the risk of transmission of HCV and HBV in the affected countries, including strict adherence to standard precautions in the healthcare setting, rigorous education and training of patients and healthcare providers, universal screening of blood donors, use of safety-engineered devices, proper sterilization of medical equipment, hepatitis B vaccination, as well as effective direct-acting antiviral agents for the treatment of HCV.
Collapse
Affiliation(s)
- Issam I Raad
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Anne-Marie Chaftari
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States.
| | - Harrys A Torres
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Ehab Mouris Ayoub
- Department of Internal Medicine, Harpur Memorial Hospital, Menouf 32951, Egypt
| | | | - Jalen Bartek
- Division of Internal Medicine, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Ray Hachem
- Department of Infectious Diseases, Infection Control and Employee Health, the University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, United States
| |
Collapse
|
15
|
Chaabna K, Cheema S, Abraham A, Alrouh H, Lowenfels AB, Maisonneuve P, Mamtani R. Systematic overview of hepatitis C infection in the Middle East and North Africa. World J Gastroenterol 2018; 24:3038-3054. [PMID: 30038471 PMCID: PMC6054949 DOI: 10.3748/wjg.v24.i27.3038] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/10/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To assess the quality of and to critically synthesize the available data on hepatitis C infections in the Middle East and North Africa (MENA) region to map evidence gaps. METHODS We conducted an overview of systematic reviews (SRs) following an a priori developed protocol (CRD42017076736). Our overview followed the preferred reporting items for systematic reviews and meta-analyses guidelines for reporting SRs and abstracts and did not receive any funding. Two independent reviewers systematically searched MEDLINE and conducted a multistage screening of the identified articles. Out of 5758 identified articles, 37 SRs of hepatitis C virus (HCV) infection in populations living in 20 countries in the MENA region published between 2008 and 2016 were included in our overview. The nine primary outcomes of interest were HCV antibody (anti-) prevalences and incidences in different at-risk populations; the HCV viremic (RNA positive) rate in HCV-positive individuals; HCV viremic prevalence in the general population (GP); the prevalence of HCV co-infection with the hepatitis B virus, human immunodeficiency virus, or schistosomiasis; the HCV genotype/subtype distribution; and the risk factors for HCV transmission. The conflicts of interest declared by the authors of the SRs were also extracted. Good quality outcomes reported by the SRs were defined as having the population, outcome, study time and setting defined as recommended by the PICOTS framework and a sample size > 100. RESULTS We included SRs reporting HCV outcomes with different levels of quality and precision. A substantial proportion of them synthesized data from mixed populations at differing levels of risk for acquiring HCV or at different HCV infection stages (recent and prior HCV transmissions). They also synthesized the data over long periods of time (e.g., two decades). Anti-HCV prevalence in the GP varied widely in the MENA region from 0.1% (study dates not reported) in the United Arab Emirates to 2.1%-13.5% (2003-2006) in Pakistan and 14.7% (2008) in Egypt. Data were not identified for Bahrain, Jordan, or Palestine. Good quality estimates of anti-HCV prevalence in the GP were reported for Algeria, Djibouti, Egypt, Iraq, Morocco, Pakistan, Syria, Sudan, Tunisia, and Yemen. Anti-HCV incidence estimates in the GP were reported only for Egypt (0.8-6.8 per 1000 person-year, 1997-2003). In Egypt, Morocco, and the United Arab Emirates, viremic rates in anti-HCV-positive individuals from the GP were approximately 70%. In the GP, the viremic prevalence varied from 0.7% (2011) in Saudi Arabia to 5.8% (2007-2008) in Pakistan and 10.0% (2008) in Egypt. Anti-HCV prevalence was lower in blood donors than in the GP, ranging from 0.2% (1992-1993) in Algeria to 1.7% (2005) in Yemen. The reporting quality of the outcomes in blood donors was good in the MENA countries, except in Qatar where no time framework was reported for the outcome. Some countries had anti-HCV prevalence estimates for children, transfused patients, contacts of HCV-infected patients, prisoners, sex workers, and men who have sex with men. CONCLUSION A substantial proportion of the reported outcomes may not help policymakers to develop micro-elimination strategies with precise HCV infection prevention and treatment programs in the region, as nowcasting HCV epidemiology using these data is potentially difficult. In addition to providing accurate information on HCV epidemiology, outcomes should also demonstrate practical and clinical significance and relevance. Based on the available data, most countries in the region have low to moderate anti-HCV prevalence. To achieve HCV elimination by 2030, up-to-date, good quality data on HCV epidemiology are required for the GP and key populations such as people who inject drugs and men who have sex with men.
Collapse
Affiliation(s)
- Karima Chaabna
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Hekmat Alrouh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| | - Albert B Lowenfels
- Department of Surgery and the Department of Family Medicine, New York Medical College, Valhalla, NY 10595, United States
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan 20141, Italy
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Doha 24144, Qatar
| |
Collapse
|
16
|
Ma W, Soliman AS, Anwar WA, Hablas A, El Din TB, Ramadan M, Seifeldin IA, Wilson ML. Forecasted impacts of a sofosbuvir-based national hepatitis C treatment programme on Egypt's hepatocellular cancer epidemic: simulation of alternatives. BMJ Glob Health 2018; 3:e000572. [PMID: 29707244 PMCID: PMC5914708 DOI: 10.1136/bmjgh-2017-000572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 03/15/2018] [Accepted: 03/24/2018] [Indexed: 02/07/2023] Open
Abstract
Background Egypt is experiencing a hepatocellular cancer (HCC) epidemic due to widespread hepatitis C virus (HCV) transmission. The use of sofosbuvir-related therapies producing improved treatment success has permitted an updated, nationwide, HCV treatment programme with expanded coverage. This study simulated the multidecade impacts of the new treatment programme on hepatitis and HCC. Methods A Markov model of HCV infection and treatment analysed the HCV-related HCC epidemic between 2009 and 2050, using parameters based on peer-reviewed studies and expert opinion. Comparing the ‘new’ and ‘old’ scenarios, and with the old treatment programme being replaced or not by the new programme in 2015, the annual number, prevalence and incidence of HCC were simulated for representative Egypt populations including HCV-infected patients aged 15–59 years in 2008, healthy people aged 5–59 years in 2008 and 5-year-old children cohorts entering the population each year beginning in 2009. Averted HCC cases were calculated, and sensitivity analyses were performed. Results Compared with the old scenario, the estimated number, prevalence and incidence of future HCC cases in the new scenario would peak earlier and at lower levels in 2025 (~29 000), 2023 (~28/100 000) and 2022 (~14/100 000), respectively. The new treatment programme is estimated to avert ~956 000 HCC cases between 2015 and 2050. Discussion By reducing cancer cases and shortening the peak epidemic period, the new programme should substantially diminish the HCC epidemic across Egypt. Our timeline forecast for Egypt’s HCC epidemic, and evaluation of various disease and programme components, should be useful to other countries that are developing policies to address HCV-related liver cancer prevention.
Collapse
Affiliation(s)
- Wenkang Ma
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Amr S Soliman
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, USA
| | - Wagida A Anwar
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Hablas
- Gharbiah Cancer Registry and Tanta Cancer Center, Tanta, Egypt
| | | | - Mohamed Ramadan
- Gharbiah Cancer Registry and Tanta Cancer Center, Tanta, Egypt
| | | | - Mark L Wilson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
17
|
Khalil A, Elgedawy J, Faramawi MF, Elfert A, Salama I, Abbass A, Elsaid H, Elsebaai H. Plasma Osteopontin Level as a Diagnostic Marker of Hepatocellular Carcinoma in Patients with Radiological Evidence of Focal Hepatic Lesions. TUMORI JOURNAL 2018; 99:100-7. [DOI: 10.1177/030089161309900117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aims Hepatocellular carcinoma is one of the most aggressive malignant tumors and has limited treatment options. Needle-guided biopsies have been utilized as a tool to diagnose malignant focal hepatic lesions. These techniques are discouraged because of their complications. Nowadays, alpha fetoprotein is the most widely used tumor marker for screening and diagnosis of hepatocellular carcinoma. Nevertheless, this marker has limitations. The diagnostic role of plasma osteopontin as an adjuvant or alternative marker to alpha fetoprotein to detect hepatocellular carcinoma in Egyptian patients with focal hepatic lesions was evaluated in this study. Subject and methods Eighty participants were recruited from the Egyptian National Liver Institute and were self-assigned to three groups, namely, focal hepatic lesions (n = 40), liver cirrhosis (n = 20), and controls (n = 20). Participants' plasma osteopontin and serum alpha fetoprotein levels were determined and were compared across the three groups. Results The discriminatory ability of plasma osteopontin for hepatocellular carcinoma was lower than that of alpha fetoprotein. Osteopontin and alpha fetoprotein were not correlated with each other. Neither the gender nor the age of the patients showed a significant association with plasma osteopontin level. Conclusion Measuring plasma osteopontin level alone has no advantage over serum alpha fetoprotein in patients with focal hepatic lesions due to chronic liver disease.
Collapse
Affiliation(s)
- Ashraf Khalil
- Department of Biochemistry, National Liver Institute, Menoufiya University, Shebin Elkom
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia, Charlottesville, VA, USA
| | - Jamalat Elgedawy
- Department of Biochemistry, National Liver Institute, Menoufiya University, Shebin Elkom
| | - Mohammed F Faramawi
- Department of Epidemiology, National Liver Institute, Menoufiya University, Shebin Elkom, Egypt
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Ashraf Elfert
- Department of Biochemistry, National Liver Institute, Menoufiya University, Shebin Elkom
| | - Ibrahim Salama
- Department of Hepatobillary Surgery, National Liver Institute, Menoufiya University, Shebin Elkom, Egypt
| | - Ahmed Abbass
- Department of Biochemistry, National Liver Institute, Menoufiya University, Shebin Elkom
| | - Hala Elsaid
- Department of Biochemistry, National Liver Institute, Menoufiya University, Shebin Elkom
| | - Hatem Elsebaai
- Department of Biochemistry, College of Medicine, Menoufiya University, Shebin Elkom
| |
Collapse
|
18
|
Falla AM, Ahmad AA, Duffell E, Noori T, Veldhuijzen IK. Estimating the scale of chronic hepatitis C virus infection in the EU/EEA: a focus on migrants from anti-HCV endemic countries. BMC Infect Dis 2018; 18:42. [PMID: 29338702 PMCID: PMC5771208 DOI: 10.1186/s12879-017-2908-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 12/11/2017] [Indexed: 12/22/2022] Open
Abstract
Background Increasing the proportion diagnosed with and on treatment for chronic hepatitis C (CHC) is key to the elimination of hepatitis C in Europe. This study contributes to secondary prevention planning in the European Union/European Economic Area (EU/EEA) by estimating the number of CHC (anti-HCV positive and viraemic) cases among migrants living in the EU/EEA and born in endemic countries, defining the most affected migrant populations, and assessing whether country of birth prevalence is a reliable proxy for migrant prevalence. Methods Migrant country of birth and population size extracted from statistical databases and anti-HCV prevalence in countries of birth and in EU/EEA countries derived from a systematic literature search were used to estimate caseload among and most affected migrants. Reliability of country of birth prevalence as a proxy for migrant prevalence was assessed via a systematic literature search. Results Approximately 11% of the EU/EEA adult population is foreign-born, 79% of whom were born in endemic (anti-HCV prevalence ≥1%) countries. Anti-HCV/CHC prevalence in migrants from endemic countries residing in the EU/EEA is estimated at 2.3%/1.6%, corresponding to ~580,000 CHC infections or 14% of the CHC disease burden in the EU/EEA. The highest number of cases is found among migrants from Romania and Russia (50–60,000 cases each) and migrants from Italy, Morocco, Pakistan, Poland and Ukraine (25–35,000 cases each). Ten studies reporting prevalence in migrants in Europe were identified; in seven of these estimates, prevalence was comparable with the country of birth prevalence and in three estimates it was lower. Discussion Migrants are disproportionately affected by CHC, account for a considerable number of CHC infections in EU/EEA countries, and are an important population for targeted case finding and treatment. Limited data suggest that country of birth prevalence can be used as a proxy for the prevalence in migrants. Electronic supplementary material The online version of this article (doi: 10.1186/s12879-017-2908-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- A M Falla
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. .,Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, PO Box 70032, 3000, LP, Rotterdam, The Netherlands.
| | - A A Ahmad
- Department of Health Sciences, Hamburg University of Applied Sciences, Faculty Life Sciences / Public Health Research, Ulmenliet 20, 21033, Hamburg, Germany.,Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr 52, 20246, Hamburg, Germany
| | - E Duffell
- European Centre for Disease Prevention and Control, Granits väg 8, 171 65, Solna, Sweden
| | - T Noori
- European Centre for Disease Prevention and Control, Granits väg 8, 171 65, Solna, Sweden
| | - I K Veldhuijzen
- Division of Infectious Disease Control, Municipal Public Health Service Rotterdam-Rijnmond, PO Box 70032, 3000, LP, Rotterdam, The Netherlands.,Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| |
Collapse
|
19
|
Nada Y, Rashad N, Eissa M, Ghonaim A, Farag K, Saadawi I, Sheha A, El Gewaity M, Abdel-Rahman O. Outcomes of treatment with sorafenib in Egyptian patients with hepatocellular carcinoma: a retrospective cohort study. Expert Rev Gastroenterol Hepatol 2018; 12:99-107. [PMID: 29124987 DOI: 10.1080/17474124.2018.1403898] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Sorafenib is the standard of care, first line treatment for advanced HCC. This study aims to evaluate real-life efficacy and safety of sorafenib in Egyptian patients with Hepatocellular carcinoma (HCC). METHODS This retrospective cohort study was conducted in the medical oncology department at Maadi Armed Forces Medical Compound. Patients with advanced HCC who received sorafenib between January and December 2015 were included (130 patients). RESULTS The median overall survival of patients with HCC treated with sorafenib was 5 months (CI: 4.166-5.834), and progression free survival was 4 months (CI: 3.479-4.521). Disease control rate was 45.44% with 2 patients experiencing complete remission (1.2%). The adverse events rate was 76.1% for toxicities of all grades; with hand and foot syndrome being the most common (32.3% of any grade) and liver dysfunction the most common grade III toxicity (13.8%). Treatment was stopped for radiological progression based on modified RECIST criteria in 47 patients (36.3%), 18 patients stopped the treatment for intolerable toxicity. At the end of treatment upon radiological progression, 51 patients (39.2%) were still classified as Child A class of cirrhosis. CONCLUSION Sorafenib use should be limited to patients with Child A, PS 0-1, and low disease burden.
Collapse
Affiliation(s)
- Yousery Nada
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Noha Rashad
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Mai Eissa
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Aya Ghonaim
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Kyrillus Farag
- b Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| | - Islam Saadawi
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Ahmed Sheha
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Mahmoud El Gewaity
- a Medical Oncology Department , Maadi Armed Forces Medical Compound, Oncology and Hematology Hospital , Cairo , Egypt
| | - Omar Abdel-Rahman
- b Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt
| |
Collapse
|
20
|
Mohamed AA, Elshimy AA, El Sadik AO, Ezzat E, Nasar M, Elshaer SSM, Sayed MM. Association between Severity of Liver Disease, Frequency of Helicobacter pylori Infection, and Degree of Gastric Lesion in Egyptian Patients with Hepatitis B Virus Infection. Am J Trop Med Hyg 2018; 98:221-226. [PMID: 29342404 PMCID: PMC5928701 DOI: 10.4269/ajtmh.17-0291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 09/18/2017] [Indexed: 12/14/2022] Open
Abstract
The relationship between hepatitis B virus (HBV) infection, severity of liver disease, frequency of Helicobacter pylori infection, and degree of gastric lesions was not yet fully investigated in Egyptian patients. The present work was performed on 100 Egyptian patients with HBV from the National Hepatology and Tropical Medicine Institute and 70 healthy volunteers as control group. The participants were subjected to full medical history taking, clinical examination, and laboratory investigations. All patients were positive for HBV surface antigen (HBV sAg), HBV DNA, and negative for hepatitis C virus antibodies. The severity of the liver disease was assessed using Child-Pugh scoring system. Screening of all participants for H. pylori Ag in stool was performed. Biopsy specimens were taken from the gastric lesions of H. pylori-infected patients for histopathological examination. The mean age of the patients and control group were 34.9 and 33.4 years, respectively. The levels of the liver enzymes were statistically higher in HBV patients than the control group. Helicobacter pylori Ag in stool was detected in 45.7% of the control group, and a higher percentage (60%) was detected in the patients group. Chronic gastritis with glandular atrophy and metaplasia was found in 15.6% of patients of Child-Pugh A, 70% of Child-Pugh B, and 100% of Child-Pugh C. It could be concluded that the prognosis of the liver disease significantly influences the severity of the gastric pathology in H. pylori infection.
Collapse
Affiliation(s)
- Amal A. Mohamed
- Department of Biochemistry and Molecular Biology, National Hepatology and Tropical Medicine Research institute, Cairo, Egypt
| | - Amal A. Elshimy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Cairo University, New Giza University, Cairo, Egypt
| | - Abir O. El Sadik
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, New Giza University, Cairo, Egypt
| | - Elham Ezzat
- Department of Microbiology, El Glaa Teaching Hospital, Cairo, Egypt
| | - Mona Nasar
- Department of Clinical Pathology, El Sahel Teaching Hospital, Cairo, Egypt
| | - Shereen S. M. Elshaer
- Department of Biochemistry, Faculty of Pharmacy (Girls), Al Azhar University,Cairo, Egypt
| | - Moataz M. Sayed
- Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
21
|
Katsiki N, Athyros VG, Karagiannis A. Vildagliptin: any effect on non-alcoholic fatty liver disease and serum uric acid? Re: Shelbaya S, Rakha S. Effectiveness and safety of vildagliptin and vildagliptin add-on to metformin in real-world settings in Egypt - results from the GUARD study. Curr Med Res Opin 2017;33:797-801. Curr Med Res Opin 2017. [PMID: 28631945 DOI: 10.1080/03007995.2017.1333955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Niki Katsiki
- a Second Propedeutic Department of Internal Medicine , Medical School, Aristotle University of Thessaloniki, Hippocration Hospital , Thessaloniki , Greece
| | | | - Asterios Karagiannis
- a Second Propedeutic Department of Internal Medicine , Medical School, Aristotle University of Thessaloniki, Hippocration Hospital , Thessaloniki , Greece
| |
Collapse
|
22
|
N Zekri AR, Salama H, Medhat E, Hamdy S, Hassan ZK, Bakr YM, Youssef ASED, Saleh D, Saeed R, Omran D. Potential Diagnostic and Prognostic Value of Lymphocytic Mitochondrial DNA Deletion in Relation to Folic Acid Status in HCV-Related Hepatocellular Carcinoma. ASIAN PACIFIC JOURNAL OF CANCER PREVENTION : APJCP 2017; 18:2451-2457. [PMID: 28952275 PMCID: PMC5720650 DOI: 10.22034/apjcp.2017.18.9.2451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Objective: We assessed the possibility of using mitochondrial (mt) DNA deletion as a molecular biomarker for disease progression in HCV-related hepatocellular carcinoma (HCC) and to identify its association with folic acid status. Methods: Serum folic acid and lymphocytic mtDNA deletions were assessed in 90 patients; 50 with HCC, 20 with liver cirrhosis (LC), and 20 with chronic hepatitis C (CHC) compared to 10 healthy control subjects. The diagnostic accuracy of mtDNA deletions frequency was evaluated using receiver-operating characteristic (ROC) curve analysis Survival analysis was performed using the Kaplan-Meier method. Differences in the survival rates were compared using log-rank test. Result: Our data revealed a significant elevation of mtDNA deletions frequency in the HCC group compared to the other groups (P-value <0.01). Also, our data showed a significant correlation between folate deficiency and high frequency of mtDNA deletions in patients with HCV-related HCC when compared to the other groups (r= -0.094 and P-value <0.05). Moreover, the size of the hepatic focal lesion in the HCC patients was positively correlated with mtDNA deletions (r= 0.09 and P-value <0.01). The median survival time for the HCC patients with high frequency of mtDNA deletions (∆Ct ≥3.9; 5.7+ 0.6 months) was significantly shorter than those with low mtDNA deletions frequency (∆Ct < 3.9; 11.9+ 0.04 months, P-value <0.01). Conclusion: Our data provided an evidence that lymphocytic mtDNA deletion could be used as non-invasive biomarker for disease progression and patients’ survival in HCV-related HCC. Also, our findings implied a causal relationship between the folate deficiency and the high mtDNA deletions frequency among Egyptian patients with HCV related HCC.
Collapse
Affiliation(s)
- Abdel Rahman N Zekri
- Virology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Zayed RA, Omran D, Zayed AA, Elmessery LO. Determinants of Infection Outcome in HCV-Genotype 4. Viral Immunol 2017; 30:560-567. [PMID: 28731371 DOI: 10.1089/vim.2017.0071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection represents a worldwide health problem and has been for long an attractive point of research due to diversity among different genotypes regarding unique geographical distribution and diverse treatment outcome. HCV is considered a major cause of chronic liver disease and cirrhosis, which leads to liver failure and hepatocellular carcinoma requiring liver transplantation. Of the HCV genotypes identified, HCV genotype 4 (HCV-4) is the least studied. HCV-4 is responsible for ∼10% of HCV infections and is common in the Middle East and Africa; recently it is increasingly prevalent in European Countries. HCV-4 is a continuing epidemic in Egypt, having the highest prevalence of HCV worldwide. "Know your epidemic, know your response" concept necessitates better understanding of HCV-4 characteristics to control disease dissemination and progression, which compromises the life quality of chronic HCV-infected patients. In this review, we discuss the epidemiology, natural history, and treatment options for patients with HCV-4 infection.
Collapse
Affiliation(s)
- Rania A Zayed
- 1 Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University , Giza, Cairo, Egypt
| | - Dalia Omran
- 2 Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University , Giza, Cairo, Egypt
| | - Abeer A Zayed
- 3 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Cairo University , Giza, Cairo, Egypt
| | - Lobna O Elmessery
- 1 Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University , Giza, Cairo, Egypt
| |
Collapse
|
24
|
Naguib E, Kamel A, Fekry O, Abdelfattah G. Comparative study on the effect of low intensity laser and growth factors on stem cells used in experimentally-induced liver fibrosis in mice. Arab J Gastroenterol 2017. [PMID: 28625529 DOI: 10.1016/j.ajg.2017.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND STUDY AIMS The therapeutic effects of human umbilical cord-derived mesenchymal stem cells (UC-MSCs) exposed to diode laser and/or hepatocyte growth factor (HGF) were compared in mice with experimental liver fibrosis induced by carbon tetra chloride (CCl4). MATERIAL AND METHODS Animal model of liver cirrhosis was induced by intraperitoneal injection of CCl4 in a dose of 0.4ml/kg, twice a week for 6weeks. UC-MSCs were obtained from normal full term placentas and were exposed to diode laser and/or HGF. Before treatment, UC-MSCs were labelled with red fluorescent PKH26. Fifty four male mice weighing 25-35g were randomly divided into four groups control, stem cells, CCl4, and treated groups. After the experimental period, body and liver weights were recorded, and the liver specimens were processed for histological examination using haematoxylin and eosin, Periodic Acid-Schiff (PAS), and Masson's Trichrome staining (MT). RESULTS Results showed that administration of UC-MSCs stimulated by diode laser and/or HGF improved body and liver weights, reduced vascular dilatation and congestion, reduced mononuclear cellular infiltration, reduced hepatocyte vacuolation, eosinophilia, and pyknosis. Furthermore, periportal fibrosis was minimized and PAS reaction was increased. These effects were maximum when UC-MSCs were exposed to both diode laser and HGF. CONCLUSION UC-MSCs stimulated by both diode laser and HGF proved to be an effective therapeutic option in experimental liver fibrosis induced by CCl4 in mice.
Collapse
Affiliation(s)
- Eman Naguib
- Department of Laser Sciences and Interactions, National Institute of Laser and Enhanced Sciences, Cairo University, Cairo, Egypt.
| | - Ashraf Kamel
- Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Osama Fekry
- Department of Medical Laser Applications, National Institute of Laser and Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Gamal Abdelfattah
- Department of Laser Sciences and Interactions, National Institute of Laser and Enhanced Sciences, Cairo University, Cairo, Egypt
| |
Collapse
|
25
|
Assessment of health-related quality of life after hepatocellular carcinoma management (radiofrequency ablation or transarterial chemoembolization). EGYPTIAN LIVER JOURNAL 2017. [DOI: 10.1097/01.elx.0000528001.78130.1c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|
26
|
Aly AM, Adel A, El-Gendy AO, Essam TM, Aziz RK. Gut microbiome alterations in patients with stage 4 hepatitis C. Gut Pathog 2016; 8:42. [PMID: 27625705 PMCID: PMC5020480 DOI: 10.1186/s13099-016-0124-2] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 08/23/2016] [Indexed: 02/07/2023] Open
Abstract
Background Hepatitis C virus (HCV) causes debilitating liver diseases, which may progress to cirrhosis and cancer, and claims 500,000 annual lives worldwide. While HCV epidemiology, pathophysiology, and therapy are being deeply studied, rare attention is given to reciprocal interactions between HCV infection , HCV-induced chronic liver diseases, and the human gut microbiome. As Egypt has the world’s highest prevalence of HCV infections, we launched this study to monitor differences in the gut microbial community composition of Egyptian HCV patients that may affect, or result from, the patients’ liver state. Results To this end, we analyzed stool samples from six stage 4-HCV patients and eight healthy individuals by high-throughput 16S rRNA gene sequencing using Illumina MiSeq. Overall, the alpha-diversity of the healthy persons’ gut microbiomes was higher than those of the HCV patients. Whereas members of phylum Bacteroidetes were more abundant in HCV patients, healthy individuals had higher abundance of Firmicutes, Proteobacteria, and Actinobacteria. Genus-level analysis showed differential abundance of Prevotella and Faecalibacterium (higher in HCV patients) vs. Ruminococcus and Clostridium (healthy group), indicating that the higher abundance of Bacteroidetes in HCV patients is most likely due to Prevotella overabundance. The probiotic genus, Bifidobacterium, was only observed in the microbiotas of healthy individuals. Conclusions To the best of our knowledge, this study provides a first overview of major phyla and genera differentiating stage 4-HCV patients from healthy individuals and suggests possible microbiome remodeling in chronic hepatitis C, possibly shaped by bacterial translocation as well as the liver’s impaired role in digestion and protein synthesis. Future studies will investigate the microbiome composition and functional capabilities in more patients while tracing some potential biomarker taxa (e.g., Prevotella, Faecalibacterium vs. Bifidobacterium). Electronic supplementary material The online version of this article (doi:10.1186/s13099-016-0124-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- AbdelRahman Mahmoud Aly
- Faculty of Post Graduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, 62511 Egypt
| | - AbdelReheem Adel
- Faculty of Post Graduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, 62511 Egypt
| | - Ahmed Osama El-Gendy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, 62511 Egypt
| | - Tamer M Essam
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562 Egypt
| | - Ramy K Aziz
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, 11562 Egypt
| |
Collapse
|
27
|
Hussein WM, Anwar WA, Attaleb M, Mazini L, Försti A, Trimbitas RD, Khyatti M. A review of the infection-associated cancers in North African countries. Infect Agent Cancer 2016; 11:35. [PMID: 27512409 PMCID: PMC4979152 DOI: 10.1186/s13027-016-0083-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/09/2016] [Indexed: 02/08/2023] Open
Abstract
Cancer is typically classified as a leading non-communicable disease; however, infectious agents, such as Helicobacter pylori (H. pylori), hepatitis B virus (HBV), hepatitis C virus (HCV) and human papilloma virus (HPV), contribute significantly to the pathogenesis of various cancers. Less developed countries, including countries of the North African (NA) region, endure the highest burden of infection-related cancers. The five most common infection-associated cancers in NA in order of incidence are bladder cancer, cervical cancer, liver cancer, stomach cancer, and nasopharyngeal carcinoma. This review aims to outline the epidemiologic pattern of infection-associated cancers in five NA countries (namely: Morocco, Algeria, Tunisia, Libya and Egypt) highlighting the similarities and differences across the region. The present study employed an initial literature review of peer-reviewed articles selected from PubMed, ScienceDirect and World Health Organization (WHO) databases based on key word searches without restriction on publication dates. Original research articles and reports written in French, as well as data from institutional reports and regional meeting abstracts were also included in this extensive review. Egypt, Libya, Tunisia, Algeria and Morocco were selected to be the focus of this review.
Collapse
Affiliation(s)
- Wafaa Mohamed Hussein
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Wagida A Anwar
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain ShamsUniversity, Cairo, Egypt
| | - Mohammed Attaleb
- Biology and Medical Research Unit, National Center of Energy, Sciences and Nuclear Technics, Rabat, Morocco
| | - Loubna Mazini
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Asta Försti
- Department of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany ; Center for Primary Health Care Research, Clinical Research Center, Lund University, Malmö, Sweden
| | | | - Meriem Khyatti
- Laboratory of Onco-virology, Institut Pasteur du Maroc, Casablanca, Morocco
| |
Collapse
|
28
|
Talaat RM, Adel S, Salem TA, Nasr MI. Correlation between angiogenic/inflammatory mediators in Wister rat model of liver dysplasia. J Immunoassay Immunochem 2016; 37:472-84. [DOI: 10.1080/15321819.2016.1157490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
29
|
Could serotonin be a potential marker for hepatocellular carcinoma? A prospective single-center observational study. Eur J Gastroenterol Hepatol 2016; 28:599-605. [PMID: 26741637 DOI: 10.1097/meg.0000000000000569] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is the third most common cause of cancer mortality among men worldwide. Serotonin is a biogenic amine, which may be involved in the tumorigenesis of HCC. AIM We aimed to determine whether serotonin is a dependable marker for the diagnosis of HCC in cirrhotic patients in comparison with α-fetoprotein protein (AFP) and prothrombin induced by vitamin K absence-II (PIVKA-II). PATIENTS AND METHODS Serum serotonin, AFP, and PIVKA-II were measured in 262 patients with chronic hepatitis C (CHC): 82 cirrhotic patients with HCC (group I), 80 cirrhotic patients without HCC (group II), and 100 CHC-infected patients without cirrhosis (group III); in addition, 60 healthy controls were studied (group IV). RESULTS AFP showed significant statistical differences among the groups studied (P<0.001). PIVKA-II and serotonin levels showed no statistically significant differences between the patients with CHC group and the healthy controls (P1=0.614 and P1=0.13, respectively), whereas their levels were statistically higher in cirrhotic patients than patients with CHC (all P values <0.001) and in the cirrhotic patients with HCC group than the cirrhotic patients without HCC (P<0.001). A significant positive correlation was found between serum serotonin and AFP (rho=0.794; P<0.001) and serum serotonin and PIVKA-II (rho=0.889; P<0.001) among the patient groups. The receiver operator characteristic curve showed a higher area under the curve for serotonin than AFP and PIVKA-II (0.942, 0.824, and 0.921, respectively). CONCLUSION Serotonin may be used together with PIVKA-II to screen for HCC in cirrhotic patients with CHC.
Collapse
|
30
|
Esmail MA, Hassuna NA, Amr KS, Ghazawy ER, Abdel-Hamid M. Polymorphisms at IL28B gene as predictors of viral relapse in genotype 4 Egyptian hepatitis C patients. J Med Virol 2016; 88:481-6. [PMID: 26280154 DOI: 10.1002/jmv.24354] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2015] [Indexed: 12/23/2022]
Abstract
Chronic HCV is one of the commonest causes of chronic liver disease worldwide with about 15% of population infected in Egypt. Certain single nucleotide polymorphisms (SNPs) lying near the IL28B gene were found to affect the spontaneous clearance as well as treatment outcome of HCV. To examine the association between different IL28B variants and the relapse of HCV infection after combined therapy with ribavirin and pegylated interferon (pegIFN). Hundered HCV genotype four patients received 1.5 mg/kg/week peginterferon alfa-2b plus 800-1400 mg/d ribavirin (weight-adjusted) for 48 weeks. IL28B polymorphisms (rs12980275, rs12979860, and 1 rs8099917) were studied in responders and relapsers at week 72. Out of 69 patients receiving treatment, 13 (18.8%) were relapsers. By stratifying patients on the basis of the IL-28/60 genotype (CC vs. CT/TT), CC patients showed lower relapse rates (2.3%) compared with CT/TT patients (46.2%) (P < 0.001). On the basis of the IL-28/75 genotype (GG vs. GA/AA), the GG patients achieved higher relapse rates (62.5%) compared with GA/AA patients (13.1%) (P = 0.004). Moreover, no statistical significant difference was observed between the TT patients compared with GG/GT patients on the basis of the IL-28/17 genotype. SNPs at IL-28/60 and IL-28/75 are possible predictors of relapse in patients receiving dual treatment.
Collapse
Affiliation(s)
| | - Noha A Hassuna
- Microbiology and Immunology Department, Faculty of Medicine, Minia University, Egypt
| | | | | | - Mohamed Abdel-Hamid
- Microbiology and Immunology Department, Faculty of Medicine, Minia University, Egypt
| |
Collapse
|
31
|
Wang H, Feng F, Wang XP, Wang RS, Wu Y, Zhu MG, Zhang H, Zhuang ZX. Dendritic cells pulsed with Hsp70 and HBxAg induce specific antitumor immune responses in hepatitis B virus-associated hepatocellular carcinoma. Mol Med Rep 2015; 13:1077-82. [PMID: 26647961 PMCID: PMC4732831 DOI: 10.3892/mmr.2015.4654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 06/11/2015] [Indexed: 01/30/2023] Open
Abstract
Previous studies have drawn attention to dendritic cell (DC) vaccines; particularly the application of the tumor-associated antigen-targeted DC vaccine. The present study analyzed DCs derived from a normal individual and pulsed the cells with heat shock protein 70 peptide (Hsp70) and/or hepatitis B virus x antigen (HBxAg), a hepatocellular carcinoma (HCC)-associated antigen. It was then investigated whether this method of vaccination induced strong therapeutic antitumor immunity. The results revealed that the Hsp70/HBxAg complex-activated phenotype improves the functional maturation of DCs compared with using Hsp70 or HBxAg alone. Compared with either Hsp70 or HBxAg alone, matured DCs pulsed with the Hsp70/HBxAg complex stimulated a high level of autologous T-cell proliferation and induced HCC-specific cytotoxic T lymphocytes, which specifically killed HCC cells through a major histocompatibility complex class I mechanism. These results indicated that a vaccination therapy using DCs co-pulsed with the Hsp70/HBxAg complex is an effective strategy for immunotherapy and may offer a useful approach to protect against HCC.
Collapse
Affiliation(s)
- Hui Wang
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Fang Feng
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Xiao-Ping Wang
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Rou-Shu Wang
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Ying Wu
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Min-Gao Zhu
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Hong Zhang
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Zhi-Xiang Zhuang
- Department of Oncology, The Second Affiliated Hospital, Soochow University, Suzhou, Jiangsu 215004, P.R. China
| |
Collapse
|
32
|
IL17A gene polymorphism, serum IL17 and total IgE in Egyptian population with chronic HCV and hepatocellular carcinoma. Immunol Lett 2015; 168:240-5. [PMID: 26367076 DOI: 10.1016/j.imlet.2015.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/03/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Chronic infections with HCV (CHC) induce a chronic inflammation which can lead to liver fibrosis and subsequently cirrhosis. A recent study suggests a role of IL-17 polymorphism and serum IL17 in hepatitis B related HCC. These data indicate that the IL-17 G-197A polymorphism may be a good indicator for susceptibility to cancer development. AIM To investigate the role of the IL17A gene polymorphism, serum IL17 and total IgE in Egyptian population with chronic infections with HCV and HCC. SUBJECTS AND METHODS This study was carried out on 40 patients with chronic HCV, 35 patients with hepatocellular carcinoma and 20 healthy persons as control. All subjects were submitted to History taking, clinical examination, abdominal ultrasound, laboratory tests including CBC, liver function tests, alpha fetoprotien, determination of IL17gene polymorphisms by PCR-RFLP, IL17 by ELISA and IgE by immunonephelometric assay. RESULTS In reference to AA genotype, the frequencies of GG, GA+GG genotypes in the cases with HCC were significantly different from that of the controls (p=0.012, 0.011) and carry 6.12,4.9 respectively fold increase for HCC risk and that of chronic HCV without HCC (p=0.005, 0.004) respectively. However, there was no significant difference in allele frequency in the studied groups (p=0.095). Cases with HCC significantly have higher levels of serum IL17 and IgE than both healthy control and chronic HCV. In conclusion, the present study showed the GG, GG+GA genotypes of IL17A gene is a risk factor for HCC development may be through increased IL17 and IgE and further studies with larger sample size and different populations are recommended.
Collapse
|
33
|
El Deen HS, El Haddad HE. Significance of hepatocyte growth factor concentrations in serum of patients with liver cirrhosis and patients with hepatocellular carcinoma. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2015. [DOI: 10.4103/1110-7782.165437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
|
34
|
Elrashidy H, El-Didamony G, Elbahrawy A, Hashim A, Alashker A, Morsy MH, Elwassief A, Elmestikawy A, Abdallah AM, Mohammad AGS, Mostafa M, George NM, Abdelhafeez H. Absence of occult hepatitis B virus infection in sera of diabetic children and adolescents following hepatitis B vaccination. Hum Vaccin Immunother 2015; 10:2336-41. [PMID: 25424940 DOI: 10.4161/hv.29521] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The prevalence of occult hepatitis B (HB) infection (OBI) in HB-vaccinated diabetic children has not yet been tested. Here, we aimed to determine the prevalence of OBI among HB-vaccinated children and adolescents with insulin-dependent diabetes mellitus (IDDM). RESULTS Eighty-seven (51.2%) children had a titer for antibodies to HB surface antigen (anti-HBs) of <10 IU/L. These included 44 (70%) IDDM children and 43 (40.2%) healthy children. Eighty-three (48.8%) children had an anti-HBs titer of ≥10 IU/L; they included 19 (30%) with IDDM and 64 (59.8%) healthy children. None of the enrolled children (n = 170) were reactive for total antibody to HB core antigen (anti-HBc) as determined by enzyme-linked immunosorbent assay. HB virus DNA was not detected in HB-vaccinated IDDM or healthy children and adolescents. METHOD An amount of 170 HBsAg-negative sera samples from HB-vaccinated children and adolescents was included. They were classified into the IDDM group (n = 63) and the healthy control group (n = 107). HBsAg, anti-HBc, and anti-HBs were tested by enzyme-linked immunosorbent assay, and HB virus DNA was tested by nested polymerase chain reaction using 3 pairs of surface, core, and X genes. IN CONCLUSION Primary HB vaccination confers long-term protection against OBI in Egyptian diabetic children and adolescents. However, the number of cases tested in this study was relatively low, and further studies and long-term follow-up of large populations are needed to draw solid and convincing conclusions.
Collapse
Affiliation(s)
- Heba Elrashidy
- a Department of Microbiology and Botany; Faculty of Science; Al-Zakazik University; Al-Zakazik, Egypt
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Elbahrawy A, Alaboudy A, El Moghazy W, Elwassief A, Alashker A, Abdallah AM. Occult hepatitis B virus infection in Egypt. World J Hepatol 2015; 7:1671-1678. [PMID: 26140086 PMCID: PMC4483548 DOI: 10.4254/wjh.v7.i12.1671] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 01/27/2015] [Accepted: 05/11/2015] [Indexed: 02/06/2023] Open
Abstract
The emerging evidence of the potentially clinical importance of occult hepatitis B virus (HBV) infection (OBI) increases the interest in this topic. OBI may impact in several clinical contexts, which include the possible transmission of the infection, the contribution to liver disease progression, the development of hepatocellular carcinoma, and the risk of reactivation. There are several articles that have published on OBI in Egyptian populations. A review of MEDLINE database was undertaken for relevant articles to clarify the epidemiology of OBI in Egypt. HBV genotype D is the only detectable genotype among Egyptian OBI patients. Higher rates of OBI reported among Egyptian chronic HCV, hemodialysis, children with malignant disorders, and cryptogenic liver disease patients. There is an evidence of OBI reactivation after treatment with chemotherapy. The available data suggested that screening for OBI must be a routine practice in these groups of patients. Further studies needed for better understand of the epidemiology of OBI among Egyptian young generations after the era of hepatitis B vaccination.
Collapse
|
36
|
Serological tumor markers of hepatocellular carcinoma: a meta-analysis. Int J Biol Markers 2015; 30:e32-42. [PMID: 25450646 DOI: 10.5301/jbm.5000119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND The clinical value of serum α-fetoprotein (AFP) to detect hepatocellular carcinoma (HCC) has been questioned due to its low sensitivity and specificity. Other than AFP, several new serum biomarkers including glypican-3 (GPC3), des-γ-carboxy prothrombin (DCP), α-L-fucosidase enzyme (AFU) and vascular endothelial growth factor (VEGF) have been identified as useful HCC markers. MATERIAL AND METHODS A systematic search on PubMed, Web of Science and others was performed. Twenty-six case-control studies on HCC-related biomarkers published from 2000 to 2014 were included in this analysis. Data on sensitivity and specificity of tests were extracted and analyzed using the Meta-DiSc 1.4 statistical program. Fixed or random-effects models were used depending on the absence or presence of significant heterogeneity. Summary receiver operating characteristic (sROC) curves were obtained to evaluate the accuracy of the studied markers. RESULTS The areas under the sROC curve of AFP, GPC3, DCP, AFU, VEGF and the combination of each of the last 4 markers with AFP were 0.869, 0.928, 0.832, 0.851, 0.834, 0.964, 0.972, 0.873 and 0.948, respectively. A combination of AFP+GPC3, AFP+DCP or AFP+VEGF was superior to AFP alone in detecting HCC. The area under the sROC curve of GPC3 alone was significantly higher than that of AFP, whereas the areas of DCP, AFU and VEGF were comparable to that of AFP. CONCLUSIONS GPC3, DCP, AFU and VEGF are suitable markers for HCC, and their determination with AFP may prove to be useful in the diagnosis and screening of HCC.
Collapse
|
37
|
Occult hepatitis B virus infection in children born to HBsAg-positive mothers after neonatal passive-active immunoprophylaxis. Infection 2015; 43:307-14. [PMID: 25665956 DOI: 10.1007/s15010-015-0733-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 01/19/2015] [Indexed: 01/04/2023]
|
38
|
El-Ghitany EM, Abdel Wahab MM, Abd El-Wahab EW, Hassouna S, Farghaly AG. A comprehensive hepatitis C virus risk factors meta-analysis (1989-2013): do they differ in Egypt? Liver Int 2015; 35:489-501. [PMID: 24923487 DOI: 10.1111/liv.12617] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 06/05/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS The prevention and control of HCV infection is complex and challenging in terms of describing risk factors and modes of transmission. This meta-analysis was conducted to summarize the best available data on HCV risk factors worldwide and in Egypt. METHODS Through exhaustive literature searches (1989-2013) of HCV risk factors, 357 original eligible articles were included in this study. RESULTS The highest detected risk was intravenous drug users (IDUs) (OR = 9.6) followed by HIV infection (OR = 4.9), having an IDU partner (OR = 4.1), HBV infection (OR = 3.5), Caesarean section (CS) (OR = 3.35), blood transfusion (OR = 3.2) and having an HCV+ partner (OR = 3). Organ transplantation, hospital admission, haemodialysis and having a sexually transmitted infection carry 2.96, 2.4, 2.18 and 2 risks of having HCV respectively. Other significant risk factors included poor education, older age, sharing sharp or blunt objects, MSM, tattooing, hijama, body piercing, minor operations and medical procedures. Some risks showed a decrease over the previous decade, including blood transfusion, organ transplantation, IDUs, IDU partner and CS. Others showed rising risks, including having an HCV+ partner, MSM and suffering from STI. In Egypt, male gender, rural residence, acupuncture and receiving parenteral antischistosomal treatment were significant risks, while neither HIV nor HBV were found to carry a risk of HCV infection. CONCLUSION Blood transfusion, organ transplantation, CS, IDUs, haemodialysis, minor operations and medical procedures are established risk factors. Attention and urgent intervention should be given to the sexual route of transmission, as well as that through minor operations and medical procedures.
Collapse
Affiliation(s)
- Engy Mohamed El-Ghitany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | | | | | | |
Collapse
|
39
|
Can A, Dogan E, Bayoglu IV, Tatli AM, Besiroglu M, Kocer M, Dulger AC, Uyeturk U, Kivrak D, Orakci Z, Bal O, Kacan T, Olmez S, Turan N, Ozbay MF, Alacacioglu A. Multicenter epidemiologic study on hepatocellular carcinoma in Turkey. Asian Pac J Cancer Prev 2015; 15:2923-7. [PMID: 24761926 DOI: 10.7314/apjcp.2014.15.6.2923] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatocellular cancer (HCC) is one of the important health problems in Turkey, being very common and highly lethal. The aim of this study was to determine clinical, demographic features and risk factors. MATERIALS AND METHODS Nine hundred and sixth-three patients with HCC from 13 cities in Turkey were included in this study. RESULTS Only 205 (21%) of the 963 patients were women, with a male:female predominance of 4.8:1 and a median age of 61 years. The etiologic risk factors for HCC were hepatitis B in 555 patients (57.6%), 453 (81%) in men, and 102 (19%) in women, again with male predominance, hepatitis C in 159 (16.5%), (14.9% and 22.4%, with a higher incidence in women), and chronic alcohol abuse (more than ten years) in 137 (14.2%) (16.8% and 4.9%, higher in males). The Child-Pugh score paralleled with advanced disease stage amd also a high level of AFP. CONCLUSIONS According to our findings the viral etiology (hepatitis B and hepatitis C infections) in the Turkish population was the most important factor in HCC development, with alcohol abuse as the third risk factor. The Child-Pugh classification and AFP levels were determined to be important prognostic factors in HCC patients.
Collapse
Affiliation(s)
- Alper Can
- Department of Medical Oncology, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey E-mail :
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Tarakji B, Ashok N, Alakeel R, Azzeghaibi S, Umair A, Darwish S, Mahmoud R, Elkhatat E. Hepatitis B vaccination and associated oral manifestations: a non-systematic review of literature and case reports. Ann Med Health Sci Res 2014; 4:829-36. [PMID: 25506472 PMCID: PMC4250977 DOI: 10.4103/2141-9248.144870] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B vaccine has been administered in children and adults routinely to reduce the incidence of the disease. Even though, hepatitis B vaccine is considered as highly safe, some adverse reactions have been reported. A literature search was carried out in PubMed, accessed via the National Library of Medicine PubMed interface, searching used the following keywords: Hepatitis B vaccine and complications from 1980 to 2014. A total of 1147 articles were obtained out of which articles, which discuss the complications occurring orally or occurring elsewhere in the body, which have the potential to manifest orally after hepatitis B vaccination were selected. A total of 82 articles were identified which included 58 case series or case reports, 15 review articles, 4 cross sectional studies, 3 prospective cohort studies, one retrospective cohort study and a case control study. After reviewing the literature, we observed that complications seen after Hepatitis B vaccination are sudden infant death syndrome, multiple sclerosis, chronic fatigue syndrome, idiopathic thrombocytopenic purpura, vasculititis optic neuritis, anaphylaxis, systemic lupus erytymatosus, lichen planus and neuro-muscular disorder. Of these complications, some are manifested orally or have the potential to manifest orally. Although, most of the complications are self-limiting, some are very serious conditions, which require hospitalization with immediate medical attention.
Collapse
Affiliation(s)
- B Tarakji
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - N Ashok
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - R Alakeel
- Department of Clinical Laboratory Sciences, King Saud University, Alfarabi College of Medicine, Riyadh, Saudi Arabia
| | - Sn Azzeghaibi
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - A Umair
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - S Darwish
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Rs Mahmoud
- Department of Restorative Dentistry Sciences, Alfarabi College of Dentistry and Nursing, Saudi Arabia
| | - E Elkhatat
- Department of Restorative Dentistry Sciences, Alfarabi College of Dentistry and Nursing, Saudi Arabia
| |
Collapse
|
41
|
Farid IM, Hamza IM, El-Abd DM, Mohyi AM, AbdulLatif MMA, Aref AT, Hamza DM. Transforming growth factor-β1 gene expression in hepatocellular carcinoma: a preliminary report. Arab J Gastroenterol 2014; 15:142-7. [PMID: 25475758 DOI: 10.1016/j.ajg.2014.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 09/05/2014] [Accepted: 10/28/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND STUDY AIMS The transforming growth factor (TGF)-β signalling pathway plays a dual role in hepatocarcinogenesis. It has been recognised for its role as a tumour suppressor as well as a tumour promoter depending on the cellular context. The aim of this study was to investigate the clinical significance of serum TGF-β1 level and TGF-β1 messenger RNA (mRNA) in the peripheral blood of liver cirrhosis and hepatocellular carcinoma (HCC) patients as noninvasive biomarkers in diagnosing HCC. PATIENTS AND METHODS Twenty patients were allocated to each of the liver cirrhosis and HCC groups, in addition to 20 healthy volunteers. TGF-β1 gene expression in peripheral blood was quantitated using real-time polymerase chain reaction (PCR), while serum TGF-β1 was analysed using enzyme-linked immunosorbent assay (ELISA). RESULTS TGF-β1 gene expression was significantly lower in HCC patients (median 0.401 (0.241-0.699) fold change) than in liver cirrhosis patients (median 0.595 (0.464-0.816)) (p=0.042) and normal controls (median 1.00 (0.706-1.426) fold change) (p=0.001). TGF-β1 gene expression showed significant positive correlation with serum TGF-β1 (r=0.272, p=0.036) and significant negative correlation with alpha-fetoprotein (AFP) (r=-0.528, p=0.001). Receiver operating characteristic (ROC) analysis was conducted for TGF-β1 gene expression in comparison with AFP. The area under the curve for TGF-β1 gene expression was 0.688 (95% CI=0.517-0.858) (p=0.042) and AFP was 0.869 (95% CI=0.761-0.976) (p=0.001). The sensitivity and specificity of TGF-β1 gene expression were 65% and 75%, respectively, at a cutoff value of 0.462 fold change. CONCLUSION TGF-β1 gene expression in the peripheral blood may be used as a molecular marker for the diagnosis of HCC. Additional studies on a large-scale population are necessary to gain greater insight into the impact of TGF-β1 gene expression in the pathogenesis of HCC.
Collapse
Affiliation(s)
- Ibtisam M Farid
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Iman M Hamza
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Giza, Egypt.
| | - Dina M El-Abd
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Abeer M Mohyi
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mona M A AbdulLatif
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Adel T Aref
- Oncology Department, Dubai Hospital, Dubai, United Arab Emirates
| | - Dina M Hamza
- Oncology Department, Dubai Hospital, Dubai, United Arab Emirates
| |
Collapse
|
42
|
El-Eshmawy MM, Kandil TS, El-Hafez HAA, El yazid AYA, El Hadidy EHM. Type 2 diabetes mellitus is a risk factor for hepatocellular carcinoma in Egyptian patients with HCV-related cirrhosis. Int J Diabetes Dev Ctries 2014. [DOI: 10.1007/s13410-013-0186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
43
|
Abdelgawad IA. Clinical utility of simple non-invasive liver fibrosis indices for predicting hepatocellular carcinoma (HCC) among Egyptian patients. J Clin Pathol 2014; 68:154-60. [PMID: 25430496 DOI: 10.1136/jclinpath-2014-202462] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIM Serological indices for liver fibrosis have been widely used to estimate liver fibrosis, but as far as we know they have not been tested to predict hepatocellular carcinoma (HCC). Our aim is to study the clinical usefulness of some simple non-invasive fibrosis indices in the prediction of HCC among Egyptian patients. METHODS Ninety patients with HCC who were presented to the National Cancer Institute, Cairo University, were included in this study, together with 30 patients with cirrhosis as a benign control group and 30 apparently healthy volunteers as a normal control group. FIB4 Score, Aspartate Aminotransferase (AST) to Platelet (PLT) Ratio Index (APRI) Score, AST/PLT ratio, Age/PLT Index and AST/alanine aminotransferase indices were calculated for all patients and controls and were tested for their clinical use to predict HCC. RESULTS Double combination between alpha-fetoprotein and FIB4 Score when either one was abnormal showed the highest diagnostic performance between the HCC group and the cirrhosis and control groups with sensitivity and specificity of (93% and 96%), respectively, whereas the APRI Score was the best to differentiate between the cirrhosis and control groups with sensitivity and specificity of 100% each. CONCLUSIONS Using some simple non-costly indices can accurately predict HCC and differentiate it from cirrhosis and normal control cases among Egyptian patients, it can also differentiate cirrhosis from normal controls, so can be used as diagnostic and screening tools for both HCC and liver cirrhosis among the Egyptian population.
Collapse
|
44
|
Zaghloul RA, El-Shishtawy MM, El Galil KHA, Ebrahim MA, Metwaly AA, Al-Gayyar MM. Evaluation of antiglypican-3 therapy as a promising target for amelioration of hepatic tissue damage in hepatocellular carcinoma. Eur J Pharmacol 2014; 746:353-62. [PMID: 25449037 DOI: 10.1016/j.ejphar.2014.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 11/04/2014] [Accepted: 11/05/2014] [Indexed: 01/16/2023]
Abstract
In Egypt, hepatocellular carcinoma (HCC) was predicted to continue to rise over the next few decades causing a national problem. Meanwhile, glypican-3 (GPC3), a highly expressed glypican, has emerged as a potential target for HCC immunotherapy. Therefore, we aimed to identify the impact of blocking GPC3 on liver damage in HCC as well as a possible mechanism. Fifty four HCC patients, 20 cirrhotic patients and 10 healthy subjects were recruited. Serum levels of GPC3, sulfatase-2 (SULF-2), heparan sulfate proteoglycan (HSPG), insulin-like growth factor-II (IGF-II) were measured by ELISA. In parallel, HCC was induced in 40 male Sprague-Dawley rats in presence/absence of antiGPC-3. Liver impairment was detected by investigating liver sections stained with hematoxylin/eosin and serum α-fetoprotein (AFP). Liver homogenates of GPC3, SULF-2, and HSPG were measured by ELISA. Gene expression of caspase-3 and IGF-II were assayed by RT-PCR. HCC patients showed significant elevated serum levels of GPC3, IGF-II and SULF-2 accompanied by decreased HSPG. However, treatment of HCC rats with antiGPC-3 significantly reduced serum AFP and showed nearly normal hepatocytes. In addition, antiGPC-3 significantly reduced elevated liver homogenates protein levels of GPC3 and SULF-2 and gene expression of IGF-II and caspase-3. antiGPC-3 restored the reduced hepatic HSPG. antiGPC-3 showed anti-tumor activity as well as hepatoprotective effects. antiGPC-3-chemoprotective effect can be explained by forced reduction of IGF-II expression, restoration of HSPGs, deactivation of SULF-2 and reduction of gene expression of caspase-3. Targeting GPC3 is a promising therapeutic approach for HCC.
Collapse
Affiliation(s)
- Randa A Zaghloul
- Dept. of Biochemistry, Faculty of Pharmacy, University of Mansoura, Mansoura 35516, Egypt.
| | - Mamdouh M El-Shishtawy
- Dept. of Biochemistry, Faculty of Pharmacy, University of Mansoura, Mansoura 35516, Egypt
| | - Khaled H Abd El Galil
- Dept. of Microbiology, Faculty of Pharmacy, University of Mansoura, Mansoura 35516, Egypt
| | | | - AbdelHamid A Metwaly
- Dept. of Internal Medicine, Faculty of Medicine, University of Mansoura, Mansoura 35516, Egypt
| | - Mohammed M Al-Gayyar
- Dept. of Biochemistry, Faculty of Pharmacy, University of Mansoura, Mansoura 35516, Egypt; Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| |
Collapse
|
45
|
Mohamoud YA, Miller FD, Abu-Raddad LJ. Potential for human immunodeficiency virus parenteral transmission in the Middle East and North Africa: An analysis using hepatitis C virus as a proxy biomarker. World J Gastroenterol 2014; 20:12734-12752. [PMID: 25278675 PMCID: PMC4177460 DOI: 10.3748/wjg.v20.i36.12734] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/20/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
The Middle East and North Africa (MENA) region has endured several major events of infection parenteral transmission. Recent work has established the utility of using hepatitis C virus (HCV) as a proxy biomarker for assessing the epidemic potential for human immunodeficiency virus (HIV) parenteral transmission. In this review, we use data on the prevalence of HCV infection antibody (seroprevalence) among general population and high risk population groups to assess the potential for HIV parenteral transmission in MENA. Relatively low prevalence of HCV infection in the general population groups was reported in most MENA countries indicating that parenteral HIV transmission at endemic levels does not appear to be a cause for concern. Nonetheless, there could be opportunities for localized HIV outbreaks and transmission of other blood-borne infections in some settings such as healthcare facilities. Though there have been steady improvements in safety measures related to parenteral modes of transmission in the region, these improvements have not been uniform across all countries. More precautions, including infection control training programs, surveillance systems for nosocomial infections and wider coverage and evaluation of hepatitis B virus immunization programs need to be implemented to avoid the unnecessary spread of HIV, HCV, and other blood-borne pathogens along the parenteral modes of transmission.
Collapse
|
46
|
Abdel Mohsen MA, Hussein NA, Ghazal AA, El-Ghandour MK, Farouk M, Abd El-Wahab AE, Yousef AI. Angiogenic output in viral hepatitis, C and B, and HCV-associated hepatocellular carcinoma. ALEXANDRIA JOURNAL OF MEDICINE 2014. [DOI: 10.1016/j.ajme.2014.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Mohamed A. Abdel Mohsen
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, 165 El-Horria Ave., P.O. 21561, Alexandria, Egypt
| | - Neveen A. Hussein
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, 165 El-Horria Ave., P.O. 21561, Alexandria, Egypt
| | - Abeer A. Ghazal
- Microbiology Department, Medical Research Institute, Alexandria University, 165 El-Horria Ave., P.O. 21561, Alexandria, Egypt
| | - Marwa K. El-Ghandour
- Chemical Pathology Department, Medical Research Institute, Alexandria University, 165 El-Horria Ave., P.O. 21561, Alexandria, Egypt
| | - Mohamed Farouk
- Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Alexandria University, Egypt
| | - Abeer E. Abd El-Wahab
- Medical Biotechnology Department, City for Scientific Research & Technology Application, Egypt
| | - Amany I. Yousef
- Applied Medical Chemistry Department, Medical Research Institute, Alexandria University, 165 El-Horria Ave., P.O. 21561, Alexandria, Egypt
| |
Collapse
|
47
|
Development of a novel score for early detection of hepatocellular carcinoma among high-risk hepatitis C virus patients. Tumour Biol 2014; 35:6501-9. [PMID: 24687551 DOI: 10.1007/s13277-014-1858-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 03/17/2014] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between vascular endothelial growth factor (VEGF) and HCC progression, we aimed to develop a novel score based on combination of VEGF and routine laboratory tests for early prediction of HCC. VEGF was assayed for HCC group (123), liver cirrhosis group (210), and control group (50) by enzyme-linked immunosorbent assay (ELISA). Data from all groups were retrospectively analyzed including α-fetoprotein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under receiving operating curve (ROC) were used to develop the score. A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-VEGF score) = 1.26 (numerical constant + 0.05 × AFP (U l(-1)) + 0.038 × VEGF (ng ml(-1)) + 0.004 × INR - 1.02 × albumin (g l(-1)) - 0.002 × platelet count × 10(9) l- (1) was developed. HCC-VEGF score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91 % and specificity of 82 % at cutoff 4.4 (i.e., less than 4.4 considered cirrhosis and greater than 4.4 considered HCC). Hepatocellular carcinoma-VEGF score could replace AFP in HCC screening and follow up of cirrhotic patients.
Collapse
|
48
|
Abou El Azm AR, Yousef M, Mansour N, Awad A, El Dardiry S, Abdel Aziz I. New Insights on Non-B non-C Hepatocellular Carcinoma in Mid Delta Region, Egypt. J Gastrointest Cancer 2014; 45:276-83. [DOI: 10.1007/s12029-013-9573-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
49
|
Sellner J, Steiner I. Neurologic complications of hepatic viruses. HANDBOOK OF CLINICAL NEUROLOGY 2014; 123:647-61. [PMID: 25015509 DOI: 10.1016/b978-0-444-53488-0.00031-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Johann Sellner
- Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Klinikum rechts der Isar, Technische Universität Munich, Germany
| | - Israel Steiner
- Department of Neurology, Rabin Medical Center, Petach Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
50
|
Abdelgawad IA, Mossallam GI, Radwan NH, Elzawahry HM, Elhifnawy NM. Can Glypican3 be Diagnostic for Early Hepatocellular Carcinoma among Egyptian Patients? Asian Pac J Cancer Prev 2013; 14:7345-9. [DOI: 10.7314/apjcp.2013.14.12.7345] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|