Serum levels of soluble Fas, soluble tumor necrosis factor-receptor II, interleukin-2 receptor and interleukin-8 as early predictors of hepatocellular carcinoma in Egyptian patients with hepatitis C virus genotype-4

The following patients were recruited: 79 with HCV infection, 30 with HCC, 32 with chronic liver disease associated with elevated liver enzyme levels (with or without cirrhosis) in addition to 17 with chronic HCV with persistent normal alanine aminotransferase levels (PNALT). Nine normal persons negative either for HCV or for hepatitis B virus were included as a control group. All persons were tested for sFas, sTNFR-II, IL-2R and IL-8 in their serum by quantitative ELISA. HCC patients had higher levels of liver enzymes but lower log-HCV titer when compared to the other groups. HCC patients had also significantly higher levels of sFas, sTNFR-II and IL-2R and significantly lower levels of IL-8 when compared to the other groups. Exclusion of HCC among patients having PNALT could be predicted with 90% sensitivity and 70.6% specificity when sTNFR-II is ≥ 389 pg/ml or IL-8 is < 290 pg/ml.Serum TNFR-II, IL-2Rα and IL-8, may be used as combined markers in HCV-infected cases for patients at high risk of developing HCC; further studies, however, are mandatory to check these findings before their application at the population level.Hepatocellular carcinoma (HCC) ranks as the fifth most common cancer around the world and the third most frequent cause of cancer-related death. It represents the most common primary malignant tumor of the liver and is one of the major causes of death among patients with cirrhosis [1]. The increased incidence of HCC in the United States as well as in Japan over the past 20 to 30 years [2,3] has been partially attributed to the emergence of the hepatitis C virus (HCV), an established risk factor for developing HCC [4,5]. The prevalence of HCV infection varies significantly; higher rates have been reported in African and Asian countries, whereas industrialized nations in North America, northern and western Europe, and Australia had lower prevalence rates [6]. Egypt has the highest prevalence of HCV in the world, ranging from 6 to 28% [7-10], with an a