The Association of Serum Estradiol Level with the Susceptibility and Clinicopathological Features of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease, NEARMEEN M. RASHAD, SHERWEET M. AHMED, MAHA A. FATHY and SHADY E. SHAKER
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The most common underlying causes of Hepatocellular car-cinoma (HCC) are chronic liver diseases and cirrhosis. Aim of Study: Our study aimed to investigate the serum estradiol levels in patients with nonalcoholics steatohepatitis (NASH) related HCC and to explore their correlations with clinicopathological features of HCC. Patients and Methods: A Controlled Cross-Sectional Study included 200 patients with NAFLD (181 patients with NAFLD and 23 patients with NAFLD related HCC) and 50 controls. Serum estradiol was measured by enzyme-linked immuno-sorbent assay (ELISA). Results: The serum level of estradiol was significantly lowered in patients with NAFLD (32.24±7.3pg/ml) compared to controls (42.9±3.9pg/ml). Moreover, our findings revealed lower concentrations of serum estradiol in the HCC group (28.6±5.3pg/ml) compared to the NAFLD group (33.45 ±4.3pg/ml, p<0.00 1). We found significant negative correla-tions between serum estradiol levels and clinicopathological features of HCC (portal vein thrombosis, lymph node metas-tasis, number of tumor lesions, advanced clinical stage, tumor size, tumor site, distant metastasis) in patients with NAFLD complicated with HCC. linear regression test and we observed that serum triglycerides and a-fetoprotein were significantly associated with serum estradiol among the HCC group. Conclusion: Serum estradiol level was significantly low-ered in the HCC subgroup compared to the NAFLD group and negatively correlated with clinicopathological features of HCC. Serum estradiol can be used as a promising predictor of HCC in female patients with NAFLD.