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Problem statement: Hepatocellular carcinoma will emerge as a major form of malignancy in the coming decades. The continuing high incidence of hepatocellular carcinoma, suggests that this disease will continue to represent a global health problem far into the future. Different genes encode for the various components of the human telomerase complex. These components include the human Telomerase RNA Component (hTERC) and the Telomerase Catalytic Subunit (hTERT). Correlation between Telomerase Reverse Transcriptase (hTERT) expression and telomerase activity has been reported in cancer patients. This work aimed to clarify the significance of human Telomerase Reverse Transcriptase (hTERT mRNA) as a potential molecular tumor marker for Hepatocellular Carcinoma (HCC). Approach: The current study included 25 patients of hepatocellular carcinoma (HCC), 30 patients with liver cirrhosis and 25 age and sex matched individuals with normal laboratory and Image findings as a control group. hTERT mRNA was measured in plasma by Real time PCR in all patients samples in comparison with normal healthy controls. Results: The expression of hTERT mRNA by relative unit was 129.10±27.6 with range (67.72-69.6) Vs 5245.87±2382.48 (2053-12232.90) Vs 92782.76±16158 (61783.25-118596.47) for control Vs cirrhosis Vs HCC group respectively. The hTERT expression was significantly with 699 and 33 fold increase in HCC and cirrhosis groups correspondingly when compared to that of controls p<0.05. Conclusion: It was suggested that this procedure was highly discriminating between healthy subjects and cancer patients and strongly support the idea that a valuable diagnostic test for cancer might be developed using this genetic marker in plasma. However it needs to be combined with other markers in future studies to be more specific for liver cancer.

Neonatal sepsis (NS) is regarded as one of the most common causes of morbidity and mortality among neonates worldwide. However, the magnitude of the problem is higher in low income countries, in spite of recent improvement of neonatal health care units. Accurate and early diagnosis of NS is the corner stone toward better therapeutic approach and safe outcome. Creactive protein is currently used however it has been reported to have a low specificity and to rise in blood of cases with a delay of 24 hours than other biomarkers like inerleukin-16 or procalcitonin. Therefore, identification of new biomarkers with high specificity and sensitivity is extremely needed. The current study aimed to detect changes in miR-146a serum expression levels among NS cases, neonates at high risk to develop sepsis and healthy control neonates and to assess the value of serum miR-146a as early indicator of NS. qPCR was used for detection of miR-146a serum expression among different study groups. Serum miR-146a showed differential expression of statistical significance within study groups, with the highest level in NS group and the lowest in healthy controls. Moreover, serum miR-146a showed a significant positive correlation with the CRP titer in NS group. Receiver operating characteristic (ROC) curve analysis revealed that best cut off value for miR-146a was at 0.539 relative units, with a sensitivity of 91.7%, specificity of 100% and 95.7% accuracy. As regard to CRP, the best ROC curve was at 18 mg/dL with 100% sensitivity, 86.4% specificity and 93.5% accuracy. Combination of miR-146a and CRP increased specificity, sensitivity and accuracy to 100%. Furthermore, in multivariate logistic regression analysis, only CRP and miR-146a were considered as independent risk factor for prediction of sepsis within high risk neonates. In conclusion, serum miR-146a may be a promising predictor for sepsis within the high risk neonates. However, large-scale prospective studies are required to confirm our findings. . Keywords

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