Evaluation of Long Non Coding RNA and Autophagy Related Gene Association in Hepatocellular Carcinoma

Abstract

H epatocellular carcinoma (HCC)is the most common type of primary liver cancers with high incidence and mortality rates. It is the fifth most common cancer worldwide and it’s the second leading cause of cancer-related deaths, as it is responsible for 745,000 deaths globally every year. The primary risk factor for developing HCC is cirrhosis, the major causes of which are HBV and HCV infection. Egypt has the highest prevalence of HCV worldwide and thus has rising rates of HCC representing a major health problem in Egypt. The low survival of HCC patients is attributed to late diagnosis when no therapy is effective. A condition which highlights the urgent need for novel biomarkers for early diagnosis of HCC in order to improve prognosis and survival rates significantly. The current diagnostic methods of HCC include imaging techniques, serological tumor markers analysis and histopathological confirmation. Imaging techniques include US,CT& MRI however their sensitivity for detection of small HCC nodules might be low while the histopathological confirmation carries the risk of tumor seeding in addition to being an invasive technique. As regards serological tumor markers, currently the most widely used diagnostic test is serum AFP. However AFP has many diagnostic problems; it is not elevated in a significant proportion of patients of HCC particularly in early stage which is potentially curable.. Moreover, AFP has been reported to be elevated in patients with cirrhosis or exacerbations of chronic viral hepatitis without HCC.As a direct consequence to this poor sensitivity and specificity and multiple limitations in diagnosis of HCC, AFP has been rejected for surveillance or diagnosis of HCC by the American Association for the Study of Liver Diseases guidelines (AASLD) highlighting the need for other biomarkers that would be minimally-invasive, simple and reliable for the early detection of HCC.