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Original Article

Association of serum levels of epidermal growth factor with

disease severity in patients with unresectable hepatocellular

carcinoma

1
1
Mohamed Ahmed Samy Kohla , Om Kolsoum Al-Haddad , Ali Nada ,
1
2
3
1
4
Mohamed Al-Warraky , Manar Obada , Mohamed Amer , Sameera Ezzat ,
Ashraf Abou Gabal 1
1 Department of Hepatology, National Liver Institute, Menoufia University, 32511 Menoufia, Egypt
2 Department of Radiology, National Liver Institute, Menoufia University, 32511 Menoufia, Egypt
3 Department of Clinical Biochemistry, National Liver Institute, Menoufia University, 32511 Menoufia, Egypt
4 Department of Epidemiology, National Liver Institute, Menoufia University, 32511 Menoufia, Egypt
ABSTRACT
Aim: Epidermal growth factor (EGF) is a mitogen for hepatocyte grown in vitro, and its expression is up-regulated during
liver regeneration. EGF also plays an important role in tumor initiation and progression. The goal of this study is to assess
whether EGF is associated with advanced hepatocellular carcinoma (HCC) and also whether it is a predictive factor of
shortened survival. Methods: Serum EGF levels were evaluated in a total of 151 subjects: 51 patients with unresectable
HCC, (21 of them were eligible for transarterial chemoembolization (TACE) and serum EGF levels were measured before
and 1 week after TACE), 40 patients with chronic hepatitis without cirrhosis, 40 patients with cirrhosis, and 20 healthy controls.
Patient demographic and laboratory variables were evaluated as predictive factors of survival in a Cox regression multivariate
analysis using SPSS software. Results: The mean serum level of EGF in patients with HCC was 784.49 pg/mL, which was
significantly higher (P < 0.05) than all other groups. Mean EGF level in cirrhotic patients was 144.69 pg/mL; in those with
chronic hepatitis C without cirrhosis, it was 338.64 pg/mL; and in healthy controls, it was 297.15 pg/mL. In group Ia patients
who underwent TACE, the mean serum level of EGF was 759.76 ± 287.88 pg/mL before TACE, and 801.14 ± 276.12 pg/mL
1 week after treatment (P = 0.34). On multivariate Cox regression analysis only age (P = 0.03) and higher serum EGF level
(P = 0.005), were inversely correlated with overall survival. Conclusion: EGF levels were found to be significantly higher in
HCC patients and together with age were the only predictors of poor survival in these patients. There was an increase in EGF
levels 1 week after TACE in response to hypoxia; however, this increase was not statistically significant.

Key words: Cirrhosis; epidermal growth factor; hepatocellular carcinoma; survival; transarterial chemoembolization

Address for correspondence:
Dr. Mohamed Ahmed Samy Kohla, Department of Hepatology, National Liver Institute, Menoufia University, Yassin Abd El
Ghaffar Road, Shebin El-Kom, 32511 Menoufia, Egypt. E-mail: dr_mohamedsamy@yahoo.com
Received: 18-02-2015, Accepted: 14-10-2015

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How to cite this article: Samy Kohla MA, Al-Haddad OK, Nada A, Al-
Warraky M, Obada M, Amer M, Ezzat S, Gabal AA. Association of serum
DOI: levels of epidermal growth factor with disease severity in patients with
10.4103/2394-5079.168959 unresectable hepatocellular carcinoma. Hepatoma Res 2016;2:18-25.

18 © 2016 Hepatoma Research | Published by OAE Publishing Inc.