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Objective Bleeding gastroesophageal varices are a cause of high mortality among cirrhotic patients. Aim The aim of this study was to study prognostic factors for mortality in cirrhosis associated with variceal bleeding. Patients and Methods This prospective study was conducted on 100 cirrhotic patients admitted to the Tanta University Hospital with an acute first variceal bleeding episode. Baseline clinical, laboratory, and endoscopic findings were recorded at presentation. Results During the first 6 weeks 15 patients died, 3 following the initial bleed and 12 after an early rebleed. At 6 months, a further 21 patients had died. Statistical analysis utilizing the baseline data revealed that high early death rate was associated with number of blood units transfused, lower systolic blood pressure, thrombocytopenia, increased serum creatinine and international normalized ratio (INR). High MELD, AIMS56, acute physiology and chronic health evaluation II (APACHE II) and ROCKall scores were risk factors for mortality. Risk factors for early rebleeding included presence of diabetes mellitus, leucocytosis, high Child score, model for end-stage liver disease (MELD), AIMS56, and sepsis-associated organ failure assessment (SOFA) scores. A high Child score, presence of ascites, and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis, leucocytosis, elevated alanine transaminase, aspartate transaminase, bilirubin, INR, and creatinine as well as low albumin were associated with decreased survival. Conclusion High MELD, AIMS56, APACHE II, and ROCKall scores were risk factors for mortality after acute variceal bleeding. High death rate during the first 6 weeks is associated with anemia, hypotension, thrombocytopenia, increased serum creatinine, and INR. Decreased survival at 6 months is associated with increased Child score, presence of ascites and associations such as hepatic encephalopathy and spontaneous bacterial peritonitis.

Background: hepatocellular carcinoma (HCC) represents a global health problem. It is the fifth most common solid tumor and the third cause of cancer-related mortality per year. In Egypt, it represents 75% of malignant liver tumors. Early detection and diagnosis of these cases are required for successful treatments and improved outcomes. Aim of the Work: this study aimed to detect serum galactin-3 levels in patients with HCC, liver cirrhosis and chronic viral hepatitis (HBV, or HCV) patients. Patients and Methods: this prospective study was conducted on a total of 60 patients, 20 of them with chronic viral hepatitis B or C, 20 with cirrhosis secondary to chronic viral hepatitis and 20 with HCC secondary to chronic viral hepatitis. It was carried out at the Clinical Pathology Department, Tanta University Hospital. Results: the mean galectin-3 levels were 15.5 ng/mL (±5.5) in HCC patients, 20.46 ng/mL (±7.56) in cirrhotic patients and 7.003 ng/mL (±4.24) in chronic viral hepatitis group. There were statistical differences between HCC and cirrhotic patients (P < 0.03), but they were lower in chronic hepatitis group statistically compared to cirrhosis and HCC (P < 0.001). Conclusion: serum galectin-3 levels in patients with chronic HBV or HCV may guide us about progression to cirrhosis or HCC and prognosis of the disease. In these patients, if galectin-3 levels were found to be high, serum alpha-feto protein level and ultrasonographic examination could be repeated at more frequent intervals. This may also guide us in terms of the treatment plan. Recommendations: it was recommended to measure changes of galectin-3 in hepatitis carries. Measurement of galectin-3 in a large scale of patients to explore its prognostic value.

Background: Hepatocellular carcinoma (HCC) is one of the most prevalent life threatening human cancers. Early detection of HCC remains a major challenge. Since alpha-fetoprotein (AFP), the most widely used biomarker for HCC surveillance and detection has limited utility for early stage disease, it is necessary to identify new serologic biomarkers with sufficient sensitivity and specificity for early detection. Aim of the Work:The aim of the study is to evaluate serum osteopontin (OPN) as a novel biomarker for diagnosis of HCC in Egyptian patients. Subject and Method:This study included 3 groups: Group I (control) included 30 apparently healthy subjects, group II (cirrhosis) included 30 patients with liver cirrhosis without HCC, group III (HCC) included 30 patients with HCC. All groups were subjected to the following: Full history taking, thorough clinical examination, abdominal ultrasonography, triphasic C.T, routine laboratory investigations, serum AFP, hepatitis markers and determination of serum osteopontin levels.Results: This study proved a statistically significant increase in the mean values of both serum AFP and OPN levels in HCC group when compared to both control group and cirrhotic group, in contrast there was no statistically significant difference in cirrhotic group when compared to control group. OPN at an optimal cut-off of 95 ng/ml had a better performance than AFP at a cut-off of 23 ng/ml for HCC diagnosis. The sensitivity and specificity for HCC diagnosis were 61.54 and 82.35 vs. 46.15 and 88.24. Conclusion:In the present study, we concluded that serum OPN has a better diagnostic performance than AFP for detection of HCC in Egyptian patients so, it may be considered as a promising HCC biomarker for diagnosis, particularly for those with negative AFP.