Background: Natural Killer (NK) cells have crucial roles in immune responses against malignant transformation including hepatocellular carcinoma (HCC). The NKG2D receptor has a critical role in the NK recognition of target cells. Aim: We assessed NKG2D receptor expression as a diagnostic biomarker for HCC detection and progression in Egyptian patients with hepatitis C virus (HCV)-related HCC. Methods: We classified 81 patients into three groups: chronic hepatitis (21), cirrhotic (30) and HCC (30) patients, with 36 individuals enrolled to the control group. We analyzed NK levels in peripheral blood and NKG2D receptor expression in NK cells using flow cytometry. Results: We observed a significant decrease in NKG2D (CD314) expression on circulating NK cells and frequency of NK cells expressing NKG2D (CD314) in HCC patients. Also, in patients, larger foci lesions significantly correlated with decreased NK cell numbers. Multiple foci numbers and patients with a Child score C significantly correlated with decreased circulating NK cells expressing NKG2D and decreased NKG2D expression. Conclusion: The percentage of NK cells in peripheral blood and NKG2D receptor expression could function as potential biomarkers for HCC detection and progression.

Introduction: Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. HLA-DR and CD117 (c-Kit) are important diagnostic markers of AML. Our objective is to determine the prognostic significance of HLA-DR and CD117 expressions in newly diagnosed AML patients and determine the correlation between HLA-DR and CD117 expressions and other prognostic markers such as cytogenetic abnormalities, FLT3-ITD, response to treatment, and patient's survival. Methods: This study included 100 newly diagnosed AML patients. All patients were subjected to clinical, morphological, cytochemical, cytogenetic analysis, molecular genetic analysis to detect FLT3-ITD, and Flowcytometric detection of HLA-DR, CD117, and CD 34. Results: The results showed that HLA-DR expression was found in 75 patients (77.3%), while CD117 expression was found in 63 patients (64.9%). Patients with HLA-DR expression showed significantly higher mean Hb concentration, significantly higher platelet count, associated with AML-FAB subtypes (M0, M1, and M2), CD34 expression, and favorable cytogenetic group. M3 subtype was significantly associated with HLA-DR-ve. While patients with CD117 expression showed significantly lower platelets count. Double positive patients (HLA-DR+ve/CD117+ve) showed significant association with the intermediate cytogenetic group, while double-negative patients (HLA-DR-ve/CD117-ve) were associated with the favorable and intermediate cytogenetic group and either positive (HLA-DR+ve /CD117-ve or HLA-DR-ve/CD117+ve) associated with poor cytogenetic groups. FLT3-ITD expression had significantly worse overall survival. Conclusion:The current study suggested that the expression of CD117 and HLA-DR may be a prognostic marker in AML, as they are associated with M0, M1, and M2 FAB subtypes; moreover, patients with combined HLA-DR and CD117 positive expression are associated with CD34 expression and intermediate cytogenetic group.

Timely and accurate diagnosis of mature B-cell neoplasm (MBN) subtypes is crucial for initiating a proper management plan. The aim of this study was to evaluate the diagnostic utility of CD200, CD148 and CD160 in different MBN subtypes using two discriminatory statistical techniques, namely receiver operating characteristic (ROC) curve analysis and support vector machine (SVM). This study included 86 patients with MBNs, 61 males and 25 females, whose data of medical histories and clinical examinations were collected. Fresh blood/bone marrow specimens were also collected and subjected to detailed morphological, cytogenetic and flow cytometric immunophenotypic examination. Diagnosis was established according to the 2017 WHO guidelines. The discriminatory performance of single and combined markers was assessed using ROC analysis. The discriminatory accuracy of the best markers was analyzed using SVM and compared to ROC analysis. The results revealed that CD148/CD200 demonstrated the best diagnostic utility in discriminating mantle cell lymphoma (MCL) from chronic lymphocytic leukemia (CLL), and hairy cell leukemia (HCL) from lymphoplasmacytic lymphoma (LPL) plus splenic marginal zone lymphoma (SMZL), with a sensitivity and specificity of 100% at signal ratios of >2.6 and <0.15, respectively. CD200 demonstrated equivalent diagnostic performance only in discriminating HCL from LPL plus SMZL at a signal cut-off value of >279. Discrimination between SMZL and LPL was unfeasible with any of the used markers. The discriminatory accuracy of SVM using CD148 and CD200 was comparable to that of ROC analysis. On the whole, the findings of this study indicate that CD148/CD200 demonstrated the best diagnostic utility in discriminating MCL from CLL, and HCL from LPL plus SMZL. Combined markers offer a diagnostic value, particularly in difficult cases with anomalous marker expression. SVM could be used for the efficient analysis of flow cytometric data.

Aim of the study: Despite achieving a high cure rate of chronic hepatitis C nowadays, treatment failure remains a major concern and host genetic polymorphism could have a possible relation. The aim was to evaluate the role of chemokine receptor CXCR6 gene polymorphism in treatment response to direct acting antivirals (DAAs) in chronic hepatitis C virus (HCV) patients. Material and methods:We investigated the chemokine receptor CXCR6 gene single nucleotide polymorphism rs2234358 in three groups. Responder and non-responder groups (each comprising 50 naïve patients) and a control group of 50 apparently healthy individuals were studied. Results: Genotype distribution revealed a significant difference (p = 0.037) between non-responders and the other 2 groups. Both control and responder groups showed allelic frequencies of 20% having the wild allele G and 80% having the variant allele T, while in the non-responder group 39% had G and 61% had the T alleles. Genotype GG was associated with significant increased risk of not responding to treatment by 4.25 times as compared with TT genotype (p = 0.019) and the G allele was associated with highly significant risk of not responding to treatment by 2.56 times compared with the T allele (p = 0.003). Conclusions: CXCR6 gene (rs2234358) polymorphism could have a potential role in the virological treatment response with a protective effect of the T allele. This could explain the higher treatment success rate of Egyptian HCV patients.

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