Genetic polymorphism of epidermal growth factor gene as a predictor of hepatocellular carcinoma in hepatitis C cirrhotic patients

Objectives To investigate the correlation between the epidermal growth factor (EGF) polymorphism and the risk of hepatocellular carcinoma (HCC) in hepatitis C viral (HCV)-related cirrhotic patients as well as its relation to EGF protein expression in HCC tissue. Background In Egypt, the incidence of HCC is ∼4.7% in chronic liver disease patients because of HCV infection. EGF plays an important role in hepatocyte regeneration and also plays a role in malignant transformation. A functional polymorphism in EGF was identified recently as the G/G genotype was associated with a higher risk of HCC and increased EGF expression in serum and liver tissue from HCC patients. Patients and methods This case–control study was carried out on 100 patients in the HCC clinic of the National Liver Institute, Menoufia University. Routine investigations and EGF genotyping were performed in 50 HCC patients (group I) subdivided into 25 patients with resectable HCC (subgroup IA) and 25 patients with advanced unrespectable HCC (subgroup IB). Twenty-five cirrhotic HCV patients did not have HCC (group II). There were a total of 25 healthy individuals (group III). Immunohistochemical detection of EGF was performed in HCC tissue biopsy from patients who underwent surgical resection. Results The GG genotype was associated with a significantly increased risk of HCC compared with the AG and AA genotypes (P = 0.031) in the cirrhotic group. The G allele led to a highly significant risk of HCC compared with allele A in recessive model GG versus AG + AA (P = 0.036) rather than in the dominant model GG + AG versus AA (P = 0.66). EGF expression in tumor tissue was statistically different only between GG and AG genotypes in the resectable HCC group (group IA) (P = 0.032). Conclusion The EGF gene polymorphism (GG genotype) led to a significant risk of HCC development in cirrhotic patients more than the AG and AA genotypes.