Assessment of the role of interleukin-18 in diagnosis of hepatocellular carcinoma related to hepatitis c virus infection

Background: Hepatocellular carcinoma (HCC) accounts for 90% of primary liver neoplasms. Representing one of the most common cancers and is responsible for up to 1 million deaths annually worldwide. Egypt has the highest prevalence of Hepatitis C Virus (HCV) worldwide and has rising rates of Hepatocellular carcinoma (HCC). The prognosis of most patients is unsatisfactory due to rapid clinical deterioration after the initial diagnosis. Therefore, it is very important to detect HCC and the recurrence at its earlier period. Alpha Feto protein (AFP) has been the most widely used plasma marker for diagnosis, surveillance and as a prognostic indicator of HCC patients' survival. Several studies indicated that high plasma levels of AFP are related to poor prognosis, as well as histological grades of malignancy. However, it has been recognized that AFP has a low sensitivity in detection of HCC, and that AFP level often increases in the absence of HCC. Thus the identification of novel biochemical markers for HCC remains an important goal for many laboratories around the world. Interleukin 18 (IL-18) plays a critical role in the host defense against intracellular microbe's infection and also it induces autoimmune diseases and propagating inflammatory process also it was found that, IL-18 could play a key role in the pathogenesis of HCC. Methods: This study was conducted on a total number of 120 patients admitted to Hepatology and Gastroenterology Department in Faculty of medicines, Ain Shams University. The patients of this study were subdivided as follows. Group I: included 20 normal healthy subjects (as controls). Group II: included 100 patients with Hepatocellular carcinoma confirmed by pathology, cytology, imaging (computer tomography and ultrasound) and serum α -fetoprotein. Results: The mean level of IL-18 was significantly higher in HCC patients (238.69±145.5 pg/ml) compared to the controls (52.8±13.32 pg/ml), P <0.001). There was significant positive correlation between IL18 and Tumor size. Conclusion: IL-18 could be used as an additional non invasive marker for monitoring the degree of disease severity in Hepatocellular carcinoma.