Evaluation of -Methylacyl-CoA Racemase as a Marker for Diagnosis and Prognosis of Hepatic Focal lesion in cirrhotic and non-cirrhotic patients

Abstract

Hepatocellular carcinoma (HCC) is the third leading cause of cancer mortality worldwide. HCC has unique geographic, sex, and age distributions that are likely determined by specific etiologic factors. Liver cancer is the fifth most common cancer in men and the eighth in women the mean age of HCC incidence is between the thirties and elders. However; the age-specific incidence of HCC differs in different geographical areas, especially between populations at very high and low risks. In Egypt; there is a shift in HCC incidence to younger age group over the last two decades which may be attributed to emergence of HCV infection as well as to spreading of both hepatitis B and C virus infection at younger age. Liver cirrhosis (LC) is the seventh leading cause of death in the world and is acknowledged as a premalignant condition for developing HCC.hepatitis C virus (HCV), alcohol use, and nonalcoholic fatty liver disease are the most common causes of cirrhosis.Tumor markers are substances synthesized and secreted by the malignant cells and they are not normally found and they are not biologically active if present as they present in much smaller amounts, few of them are produced in a sufficient large proportions, so they can be used as serum markers of tumors and they become helpful in screening, diagnosis and follow up of cases. P504S was a 382-amino-acid protein, which had been identified as human alpha-methyl acyl- coenzyme A racemase (AMACR).AMACR is mitochondrial enzyme that has a role in the β-oxidation of branched-chain fatty acids and fatty acid derivatives found in dairy products and red meat. These results aimed to detect value of alpha-Methyl-acyl-CoA Racemase as early diagnostic biomarker in hepatic focal lesion in cirrhotic and non-cirrhotic cases. Patients were distributed to 3 groups: Group A: -10 cases with normal pelvi-abdominal ultrasound and tri-phasic CT Group B: -25 cases known to have hepatic focal lesion and liver cirrhosis diagnosed by pelvi-abdominal ultrasound and tri-phasic CT.Group C: -25Cases known to have hepatic focal lesion without liver cirrhosis diagnosed by pelvi-abdominal ultrasound and tri-phasic CT. All patients underwent detailed clinical evaluation that included. Full medical history and clinical examination, Laboratory evaluation in addition totumor markers (alpha feto protein, Serum alpha methyl acyl CoA racemase), radiological scanning.The study showed the following results no statistically significant difference between groups regarding sex. While showed highly statistically significant difference between groups as regard age per years.And showed statistically significant difference between groups as regard hemoglobin and platelet