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16379

Early Detection of Hepatocellular Carcinoma on top of Liver Cirrhosis: The Fas Receptor and Ligand System

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Last updated: 24 Dec 2024

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Abstract

Hepatocyte aberrations, accumulation of chromosomal damage and possibly initiation of hepatic carcinogenesis is thought to be caused by the continued viral replication and the persistent attempt by a less than optimal immune response to eliminate hepatitis C virus (HCV) infected cells. The identification of the “death factors" including  Fas and its Ligand (Fas-L) as a major regulator of both apoptosis and immune function has provided insight into an attractive mechanism of tumor escape from immune clearance. Aim: To assess the hepatic expression of Fas/Fas-L, the Fas receptor (Fas-R) expression on lymphocyte, and serum soluble Fas (sFas) in an attempt to analyze the role of Fas receptor/ligand system in the multistep process of fibrosis/carcinogenesis and the possible use of the serum marker as possible candidate biomarkers for an early detection of hepatocellular carcinoma (HCC).   Material and Method:  The current study included 100 samples from cases at Theodor Bilharz Research Institute and Kasr Al Aini Hospital in Egypt. There were 90 cases of chronic hepatitis C (CHC) infection (and negative hepatitis B virus infection). There were 30 cases without liver cirrhosis, 30 cases with liver cirrhosis and 30 cases with HCC. 10 liver biopsies were taken from healthy livers as normal controls. Histopathologic study and immunohistochemistry for detection of hepatic Fas and Fas-L expression were determined for all cases. Electron microscopy (EM) and immunoelectron microscopy (IEM) examination for detection of Fas-R expression on lymphocytes were also done. sFas, liver function tests, serologic markers for viral hepatitis, and serum alpha-fetoprotein level (alpha-FP) were done.       Results:  The sFas in both HCC and CHC with cirrhosis patients were significantly higher than those of normal controls and CHC without cirrhosis (P<0.01), but there was no significant difference between the cirrhosis and HCC patients. Positive hepatic expression of  both Fas and Fas-L were significantly increased in the diseased groups (p<0. 01) compared to the control specimens. A progressive Fas and FasL increase from CHC without cirrhosis to CHC with cirrhosis followed by a decline from the latter to HCC. Apoptotic Fas and Fas-L proteins expression was significantly increased with the necroinflammatory activity and the advancement of fibrosis. There was a non-significant negative correlation between sFas and hepatic Fas. In addition a significant over expression of Fas-R on separated lymphocytes was associated with a higher frequency of apoptotic cell death as detected by EM examination. Conclusion:  The Fas receptor/ligand system was significantly involved in the process of liver cirrhosis converting into HCC. Down-regulation of Fas expression, up-regulation of Fas-L expression in hepatocytes and elevation of serum sFas level were important in tumor evasion from immune surveillance and in hepatic carcinogenesis.  

DOI

10.21608/ejhm.2011.16379

Keywords

Hepatocellular carcinoma, Cirrhosis, Fas, Fas ligand, hepatitis C

Authors

First Name

Olfat

Last Name

Hammam

MiddleName

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Affiliation

Department of Pathology, Theodor Bilharz Research Institute, Cairo, Egypt

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Orcid

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First Name

Manal

Last Name

Zahran

MiddleName

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Affiliation

Department of Hematology , Theodor Bilharz Research Institute, Cairo, Egypt

Email

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City

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Orcid

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First Name

Ola

Last Name

Mahmoud

MiddleName

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Affiliation

Department of Hematology , Theodor Bilharz Research Institute, Cairo, Egypt

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Orcid

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First Name

Sohair

Last Name

Aly

MiddleName

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Affiliation

Advanc Dental/Medical institute IPPT,USM, Malysia & Medicinial Chemistry Department of NRC,Cairo, Egypt

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First Name

Karim

Last Name

Hosny

MiddleName

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Affiliation

Department of Surgery. Faculty of Medicine (Kasr El Aini Hospital), Cairo University, Egypt

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Orcid

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First Name

Amira

Last Name

Helmy

MiddleName

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Affiliation

Department of Electron Microscop (Hematology), Theodor Bilharz Research Institute, Cairo, Egypt

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City

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Orcid

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First Name

Amgad

Last Name

Anas

MiddleName

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Affiliation

Department of Hepatology & Gasteroenterology, Theodor Bilharz Research Institute, Cairo, Egypt. Address for correspondence : Theodor Bilharz Research Institute, Cairo, Egypt

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Volume

45

Article Issue

1

Related Issue

3501

Issue Date

2011-10-01

Receive Date

2018-10-11

Publish Date

2011-10-01

Page Start

504

Page End

521

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_16379.html

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https://ejhm.journals.ekb.eg/service?article_code=16379

Order

8

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Early Detection of Hepatocellular Carcinoma on top of Liver Cirrhosis: The Fas Receptor and Ligand System

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Article

Created At

22 Jan 2023