Background and Study Aim : Hepatocellular carcinoma (HCC) is the fifth most common form of cancer worldwide and the third most common cause of cancerrelated deaths. This study was designed to investigate the therapeutic efficacy of percutaneous Radiofrequency ablation versus Microwave ablation for small HCC measuring ≤3 cm in diameter. Patients and methods : This study was carried out in Al-Mahalla Hepatology Teaching Hospital on 30 patients with cirrhosis and small HCC. All the patients were evaluated by thorough history, clinical examination, laboratory investigations, abdominal ultrasound and spiral triphasic CT. Results: The mean age was 56.2±5.8, 70% (21) were males and 30% (9) were females. There was highly statistical significant increase in liver function in MW ablation as regard AST, ALT and bilirubin, and decrease in  FP level of both groups after treatment. There was no significant difference between two groups in the response to treatment as regarding Triphasic CT and complications. Conclusion: Microwave (MW) and Radiofrequency (RF) ablation are similar in pathologic appearance and imaging characteristics, but RFA has many limitations and many complications. MW ablation offers many of the advantages of RF ablation while overcoming some of its limitations and the heat-sink effect.

Background and study aim : Portal hypertension is one of the most important complications of liver cirrhosis. Endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary additional burden to endoscopic units. This study is designed to assess insulin resistance in cirrhotic patients due to hepatitis C infection as non invasive parameter for esophageal varices. Patients and Methods :This study was conducted on 50 cirrhotic patients (Child A) post hepatitis C who attended the Hepatology Department and outpatient clinic at Shebein El Kom Teaching Hospital. All the patients were evaluated by thorough history ,clinical examination, biochemical parameters ,metabolic features, including insulin resistance by the homeostasis model assessment (HOMA), ultrasonongraphy , liver biopsy and upper gastrointestinal endoscopy to search for esophageal varices. Results : EVs (esophageal varices) were detected in 18 of 50 patients. By multivariate analysis ,the presence of EVs was independently associated with a low platelet count/spleen diameter ratio (562.75 + 99.16) , a high HOMA-IR score (5.49 + 0.754), high body mass index , low hemoglobin, low albumin, high alanine aminotransferase and high aspartate aminotransferase. Conclusion: Insulin resistance in patients with Hepatitis C virus cirrhosis (Child A) measured by HOMA-IR score significantly predicts the presence esophageal varices in this patients and can be used as non-invasive parameter for predicting esophageal varices.