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.

Background: Hepatocellular carcinoma [HCC] is one of the leading causes of cancer-related deaths worldwide. A major problem with HCC surveillance is the lack of reliable biomarkers. Serum transthyretin [TTR] may be a sensitive marker for the diagnosis of patients with liver cell damage, liver cirrhosis or hepatocellular carcinoma. Aim of the work:This study aimed to evaluate the potentiality of serum transthyretin [TTR] as a novel biomarker for detection of HCC in cirrhotic patients. Patients and Methods: This Current study was conducted on 70 patients with chronic liver disease. Also, 20 healthy person matched for age and sex were included as a control group. Patients were classified into 2 groups [30 cirrhotic patients with newly diagnosed HCC & 40 cirrhotic patients without HCC]. Serum TTR levels were measured using enzyme linked immunosorbent assay technique. Results: Serum levels of TTR were significantly much lower in HCC patients when compared to cirrhotic patients without HCC or control group [p<0.0001]. Significant decrease of serum TTR in HCC patients, with portal vein invasion or nodal invasion than in HCC without vascular or nodal invasion. The diagnostic accuracy of TTR was higher than that of AFP regarding sensitivity [83.3%] and negative predictive value [81.4%] in diagnosis of HCC. Conclusion: detection of lower level of TTR alone or in combination with other validated markers may be potentially informative biomarker for detection of HCC among cirrhotic patients at early noninvasive stage where curative treatment can be applied.