Role of Non Invasive Markers of Apoptosis in Mechanism of Hepatic Carcinogenesis

Background: Hepatocellular carcinoma (HCC) is a major public health problem in Egypt due to the high prevalence of hepatitis C viral (HCV) infection. This study aims to measure serum level of sFas, sFas L and Bcl-2 in a study population of HCV related diseases as chronic hepatitis, liver cirrhosis and HCC compared to healthy controls to assess their role in apoptosis in HCC.Subjects and Methods: 45 HCV positive patients were included in the study. These were subdivided into: 15 HCC patients, 15 chronic active hepatitis (CAH) and 15 patients with liver cirrhosis (LC). The control group was 15 healthy subjects. Levels of sFas, sFas L and Bcl-2 were determined in sera of groups by ELISA.Results: SFas and BcL-2 levels were significantly higher in all patients compared to controls (p 0.05). SFas L was significantly lower in all patients compared to the control group (p 0.05). Bcl-2 was a reliable diagnostic test denoting apoptosis in HCC with sensitivity 100%, specificity 70%, at 272ng/ml. SFas was a reliable diagnostic test denoting apoptosis in all cases with sensitivity 100%, specificity 80%, at 218ng/ml. SFas was the only reliable test to differentiate between LC, HCC at cutoff value 602.7ng/ml with sensitivity 100% and specificity 100%.Conclusion: SFas/sFas L correlates with the severity of liver disease. It may be useful to provide a rationale for developing a therapy for HCC by regulating the apoptosis mechanism monitoring the response to chemotherapy. Bcl-2 may play a role in regulating apoptosis of the liver in HCC.