Abstract:

Hypoxia is a common feature of many solid tumors, including hepatocellular carcinoma (HCC). It can promote tumor progression and induce radiation and chemotherapy resistance. Hypoxia inducible factor-1 (HIF-1) is one of the major mediators of hypoxic response, it has been demonstrated that a high level of HIF-1 in the HCC microenvironment leads to enhanced proliferation and survival of HCC cells. Accordingly, overexpression of HIF-1 is associated with poor prognosis in HCC. The study included 20 healthy subjects that served as control group, 33 patients with liver cirrhosis and 30 patients with HCC. All subjects were subjected to thorough history and clinical examination, abdominal ultrasound and laboratory investigations including; complete blood picture, liver function tests, in addition to measurement of alpha fetoprotein (AFP) and HIF-1 serum levels. The serum levels of HIF-1α
were significantly (P < 0.001) increased in HCC patients as compared to those with HCV and controls subjects. The circulating HIF-1α has a high sensitivity (100%) and specificity (90.7%) for HCC prediction than AFP (87.5% and 67.4%, respectively) and the associated high level of HIF-1α with metastatic HCC cases suggesting its role in the prognosis of HCC and it could be a useful molecular marker in HCC diagnosis, and monitoring prognosis. In conclusion, serum HIF-1α is highly sensitive and specific for detecting HCC alone or if combined with AFP. Therefore, it may play an important role in early diagnosis of HCC.