HCC is a major health problem in Egypt and its incidence is increasing. The high prevalence of HCV infection makes screening programmes and surveillance of those patients a very important tool to early detect cases of small HCCs.

AIMTo investigate the clinical utility of serum annexin A2 (ANXA2) as a diagnostic marker for early hepatocellular carcinoma (HCC).METHODSThis study was performed in HCC Clinic of Ain Shams University Hospitals, Cairo, Egypt and included: Group 1: Fifty patients with early stage HCC (Barcelona Clinic Liver Cancer stage A); Group 2: Twenty five patients with chronic liver disease; and Control Group: Fifteen healthy, age- and sex-matched subjects who were seronegative for viral hepatitis markers. The following laboratory investigations were done: Viral hepatitis markers [hepatitis B surface antigen and hepatitis C virus (HCV) antibodies], HCV RNA in HCV antibody-positive patients, serum alpha fetoprotein (AFP), and serum ANXA2 levels.RESULTSIn this study, 88% of HCC patients (n = 44) were HCV-positive, while HBV infection represented only 8% of all HCC patients (n = 4); and two patients were negative for both viral markers. A highly significant difference was found between patients with HCC and chronic liver disease as well as controls with regard to serum ANXA2 levels (130, IQR 15-240; 15, IQR 15-17; and 17, IQR 15-30 ng/mL, respectively). The area under the curve of ANXA2 was 0.865; the cut-off value was established to be 18 ng/mL with a diagnostic sensitivity of 74% and a specificity of 88%, while the sensitivity and specificity of AFP at the cut-off value of 200 ng/dL were 20% and 100%, respectively.CONCLUSIONSerum ANXA2 may serve as a biomarker for the early detection of HCC.

Aim: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. If left untreated, liver cancer has a poor prognosis with more than 90% of patients dying of the disease within 5 years of diagnosis. The aim of this study is to assess the value of combined radiofrequency ablation (RFA), followed by trans-arterial chemoembolization (TACE) in the management of HCC. Methods: Fifty HCC patients with chronic liver disease were categorized into two groups according to the modality of locoregional treatment: 25 HCC patients treated with RFA followed by TACE within 5 days and 25 HCC patients treated with TACE only. Results: Complete response was achieved in 100% and 84% of the HCC patients after 1 month from combined RFA-TACE therapy and TACE only respectively. The rate of objective response after 7 months was 84% and 44% in the RFA-TACE and TACE groups respectively. One year disease free survival rate was 56% and 24% in RFA-TACE and TACE groups respectively, and overall survival rate was 88% in the RFA-TACE group and 80% in the TACE only group. Conclusion: Combined RFA-TACE appears to be an effective modality and superior to TACE only for the treatment of HCC.