title: Circulating and intratumoral macrophages in patients with hepatocellular carcinoma: correlation with therapeutic approach.
abstract: BACKGROUND
  Hepatocellular carcinoma arises in an environment of chronic injury, and wound-healing responses may vary by treatment.
  
  
  METHODS
  Peripheral blood myeloid populations were quantified in 39 patients with hepatocellular carcinoma treated with surgical or endoluminal therapy. Macrophages were quantified in tissue when available.
  
  
  RESULTS
  There was a similar expansion of myeloid populations after operative procedures compared with endoluminal treatments. Immunostaining for CD68 revealed no significant differences in the number of macrophages within benign versus malignant tumors and when tumors were compared with nontumor liver. Cytotoxic CD8+ T cells were rare within tumors compared with the surrounding liver (P < .0001). Progression-free survival was reduced in patients with preoperative peripheral blood monocyte expansion (P < .05).
  
  
  CONCLUSIONS
  These data provide preliminary evidence of poor prognostic significance of elevated peripheral blood monocyte counts. We propose that the inflammatory environment of hepatocellular carcinoma may represent a consistent feature to both predict and alter the course of disease.
authors.affiliation: Hepatobiliary Surgery, The Oregon Clinic, 4805 NE Glisan Street, Suite 6N50, Portland, OR, USA. philippa.newell@providence.org
authors.forename: Pippa
authors.initials: P
authors.lastname: Newell
authors.forename: Ben
authors.initials: B
authors.lastname: Cottam
authors.forename: Talicia
authors.initials: T
authors.lastname: Savage
authors.forename: Chet
authors.initials: C
authors.lastname: Hammill
authors.forename: Ron
authors.initials: R
authors.lastname: Wolf
authors.forename: Carlo
authors.initials: C
authors.lastname: Bifulco
authors.forename: Hong D
authors.initials: HD
authors.lastname: Xiao
authors.forename: Todd
authors.initials: T
authors.lastname: Crocenzi
authors.forename: Paul
authors.initials: P
authors.lastname: Hansen
authors.forename: Marka
authors.initials: M
authors.lastname: Crittenden
authors.forename: Michael
authors.initials: M
authors.lastname: Gough
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000276:immunology* / Q000628:therapy; D017115:Catheter Ablation; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008099:Liver / Q000276:immunology*; D008113:Liver Neoplasms / Q000097:blood / Q000276:immunology* / Q000628:therapy; D008264:Macrophages / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D022423:Myeloid Cells / Q000378:metabolism; D016896:Treatment Outcome