16 ISSN 1925-9611[Print] ISSN 1925-962X[Online] www.cscanada.net www.cscanada.org Gastroenterology and Hepatology Vol. 1, No. 1, 2014, pp. 16-19 DOI: 10.3968/5289 Copyright © Canadian Research & Development Center of Sciences and Cultures Serum Squamous Cell Carcinoma Antigen Level in Cirrhotic Chronic Hepatitis C Patients With and Without Hepatocellular Carcinoma Alaa El Din Mohamed Abdo [a],* ; Akram Abd El-Moneim Deghady [b] ; Essam El Din Saeed Bedewy [a] ; Walid Ismail Ellakany [a] [a] Tropical Medicine Department, Faculty of medicine, Alexandria University, Alexandria, Egypt. [b] Chemical Pathology Department, Faculty of medicine, Alexandria University, Alexandria, Egypt. * Corresponding author. Received April 14, 2014; accepted June 16, 2014 Publish online August 31, 2014 Abstract This study will be carried out on 500 personnel divided into five groups: Group A: 100 cases of hepatocellular carcinoma without interventions. Group B: same 100 cases of group A before and 3 months after successful interventions.Group C: 100 cases of established cirrhosis. Group D: 100 cases with chronic hepatitis C virus infection without established cirrhosis. Group E: 100 healthy individuals as controls. Methods: Sera from selected patients and controls have been used for estimation of SCC-Ag using CanAg SCC EIA. Results: high significant increase in serum SCCA level in patients with HCC (groupA and groupB) when compared to cirrhotic, chronic HCV and control groups (P < 0.001). Positive significant correlation was found between AFP and serum SCCA level .The best cut-off value to differentiate HCC patients from cirrhotic patients was 3.2 ng/ml for SCCA yielded with 80% sensitivity and 90% specificity. When combined sensitivity of both markers was calculated in our study at the best-chosen cutoff values (SCCA 3.2 ng/ml and AFP 200 ng/ml) sensitivity improved to 93%. Conclusion: Combined SCCA and AFP can be used as in diagnosis of HCC and follow up 3 months after therapeutic intervention. Key words: Hepatocellular carcinoma; Squamous cell carcinoma antigen; Alfa feto protein Abdo, A. E. D. M., Deghady, A. A. E. M., Bedewy, E. E. D. S., & Ellakany, W. I. (2014). Serum Squamous Cell Carcinoma Antigen Level in Cirrhotic Chronic Hepatitis C Patients With and Without Hepatocellular Carcinoma. Gastroenterology and Hepatology , 1 (1), 16-19. Available from: http://www.cscanada.net/index.php/gh/article/view/5289 DOI: http://dx.doi.org/10.3968/5289 INTRODUCTION Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. HCC is the fifth most common malignancy in the world and the third most common cause of cancer related deaths worldwide. It is a major health problem in Egypt with the incidence expected to rise continuously in the next decade. [1-2] The diagnosis of liver cancer depends on both screening with alpha-fetoprotein (AFP) and radiological imaging studies. Generally, normal levels of AFP are below 10 ng/ ml but AFP greater than 200 ng/ml is suggestive of HCC . The sensitivity of AFP for liver cancer is about 67%; therefore a normal AFP does not exclude HCC. Searching another tumor marker, that together with AFP could improve the diagnostic utility of HCC. [3] Squamous cell carcinoma antigen (SCCA), a member of the high molecular weight family of serine protease inhibitors named serpins which are physiologically found in the granular layers of normal squamous epithelium but found to be typically expressed by neoplastic cells of epithelial origin in a number of different cancers for example cancer cervix, lung, and head and neck cancers hence, it can be used as a clinical marker of these malignancies. [4] The structure of the serpin ovalbumin revealed the archetype native serpin fold that typically have three β-sheets (termed A, B and C) and eight or nine α-helices (hA-hI). Serpins also possess an exposed region termed