Life Science Journal, 2012;9(2) http://www.lifesciencesite.com http://www.lifesciencesite.com editor@ Life Science Journal.org 930 Serum Interleukin-6 (IL-6), Vascular Endothelial Growth Factor (VEGF), and VEGF/Platelets Ratio as Markers for Hepatocelluar Carcinoma Ehab F. Moustafa 1 , Ghada M. Galal 2, Sahar M. Hassany 1 , Mohamed Z. Abd Elrahman 3 , and Madleen Adel A. Abdou 3 1 Department of Tropical Medicine and Gastroenterology, Faculty of Medicine Assiut University 2 Department of Tropical Medicine and Gastroenterology, Faculty of Medicine Sohag University 3 Clinical Pathology Department, Faculty of Medicine, Assiut University ehabmostafa_99@yahoo.com Abstract: Background: Primary liver cancer is the fifth most common cancer worldwide and the third most common cause of cancer mortality. Aim of the work: To evaluate the usefulness of serum IL-6, serum VEGF, and VEGF/Platelets ratio in hepatocellular carcinoma (HCC) diagnosis. Patients and methods: Fifty-eight cirrhotic patients with hepatocellular carcinoma were included in the study (51 males and 7 females) and 18 liver cirrhosis patients without HCC (15 males and 3 females) were recruited as a control group. All patients were subjected to full medical history, clinical examination, laboratory investigations complete blood count, liver function tests, AFP, serum IL-6, serum VEGF and calculation of VEGF/platelets ratio. Results: Patients had significantly higher values of AFP (P=0.0001), IL-6 (P=0.004), VEGF (P =0.001) and VEGF/Platelets ratio (P =0.005) than cirrhotic patients without HCC (control group). Sensitivity and specificity of serum IL-6, VEGF and VEGF/Platelets in detecting HCC, was found to be 34.5 % & 94.4%, 43.1 % & 88.9% and 41.4 % & 88.9% respectively. Sensitivity and specificity of serum IL-6, serum VEGF and VEGF/platelets ratio for detection of portal vein thrombosis were 65.5% & 83.3%, 63,8% & 77,8%, and 58,6% & 72,2% respectively. There was significant positive correlation between VEGF and AFP (r=0.794, P =0.0001), VEGF/Plat and AFP (r=0.760, P =0.0001) and IL-6 and AFP (r=0.804, P = 0.0001). Conclusion: Serum IL-6, serum VEGF, and VEGF/platelets ratio are significantly higher in HCC patients than liver cirrhosis patients without HCC. The clinical utility of these biomarkers in HCC diagnosis is still doubtful because their sensitivity is not more than that of AFP. They may have a good role in detection of portal vein thrombosis (tumor invasion). [Ehab F. Moustafa, Ghada M. Galal , Sahar M. Hassany, Mohamed Z. Abd Elrahman, and Madleen Adel A. Abdou. Serum Interleukin-6 (IL-6), Vascular Endothelial Growth Factor (VEGF), and VEGF/Platelets Ratio as Markers for Hepatocelluar Carcinoma. Life Science Journal. 2012;9(2):930-938]. (ISSN:1097-8135). http://www.lifesciencesite.com . 138 Key words: Hepatocellular carcinoma, diagnosis, vascular endothelial growth factor, IL-6, alpha feto protein. Abbreviations: hepatocellular carcinoma (HCC), vascular endothelial growth factor (VEGF), Plt (platelets), AFP (alpha feto protein). 1. Introduction Primary liver cancer is the fifth most common cancer worldwide and the third most common cause of cancer mortality (1) . Hepatocellular carcinoma (HCC) accounts for between 85% and 90% of primary liver cancers (2) . Its incidence is increasing worldwide ranging between 3% and 9% annually (3) . In Egypt, HCC was reported to account for about 4.7% of chronic liver disease (CLD) patients (4) . More than 80% of cases of HCC occur in a background of cirrhosis and most frequently involve the right lobe (2, 5) . Major causes of cirrhosis are HBV, HCV, and alcohol. Investigations in Egypt during the last decade have shown the increasing importance of HCV infection in the etiology of liver cancer, estimated to account for 40–50% of cases, and the declining influence of HBV and HBV/HCV infection (25% and 15%, respectively) (6,7) . Recently, the survival of patients with HCC after diagnosis has improved (8), which is attributed to advances in diagnostic techniques and to the application of various curative treatment options (surgical resection, liver transplantation, and percutaneous ablation). The major diagnostic modalities for HCC include serum markers, various imaging modalities and histological analysis. The overall sensitivity and accuracy of US-guided biopsy generally exceeds 85% (9) . There are virtually no false-positive findings. The negative predictive value of biopsy remains low. Therefore, in patients with negative biopsy findings, HCC cannot be definitely ruled out. Pathologically, patients with chronic liver disease, particularly those associated with a high degree of hepatocyte regeneration, can express AFP in the absence of cancer. Also, AFP is elevated in