Background: Liver cancer, predominantly hepatocellular carcinoma (HCC), is the second 
most deadly cancer worldwide. HCC is the most rapidly increasing cause of cancer-related 
mortality in the U.S. In Canada, total health care costs associated with HCV are expected to 
increase by 60% until they peak in 2032. Given the extremely frequent tumour recurrence 
even after aggressive treatment (70% after 5 years of surgical resection) and limited treatment 
options available for advanced-stage liver disease, including liver transplantation, a costly 
proposition, prevention of HCC development in patients with advanced liver fibrosis may be 
the most effective strategy to substantially impact patient survival. Aim of study: to detect 
the level of miR224 in different stages of hepatocellular carcinoma. Methods: An 
observational study, in Tropical Medicine Department, El-Minia University Hospital, ElMinia,-Egypt. Patients with hepatocellular carcinoma on top of HCV induced Liver cirrhosis
collected among the patients of tropical medicine department from January 2017 to January
2018. Patients were divided into 3 groups according to Barcelona classification of liver cancer 
(BCLC) into, group 1 with BCLC A, group 2 with BCLC B, group C with BCLC C, and 
control group of LC without HCC, for all groups: history, examination and routine 
investigations, abdominal ultrasound, Multislice CT scan and miR-224 assay were done.
Results: there was a significant difference between the level of miR 224 in different stages 
of hepatocellular carcinoma with the lowest level in BCLC A and the highest level in BCLC 
C with P value 0.001 indicating its role in predicting aggressiveness of hepatocellular 
carcinoma. Conclusion: miR-224 could serve as a good prognostic biomarker for HCC, and 
can be used as a marker predicting aggressiveness of HCC.