title: Prevalence and clinical relevance of T-helper cells, Th17 and Th1, in hepatitis B virus-related hepatocellular carcinoma.
abstract: OBJECTIVE
  An immune imbalance in the cytokine profile exerts a profound influence on the progression of hepatitis B virus (HBV) infections and hepatocellular carcinoma (HCC). The present study evaluated the immune status of T helper (Th) 17 and Th1 cells in patients with HBV-related and non-HBV-related HCC.
  
  
  METHODS
  We randomly enrolled 150 patients with HCC. Blood samples and tissue samples were obtained. The distributions and phenotypic features of Th17 and Th1 cells were determined by flow cytometry and/or immunohistochemistry.
  
  
  RESULTS
  Compared to corresponding non-tumor regions, the levels of Th17 and Th1 cells were significantly increased in tumors of patients with HCC (P<0.001). The intratumoral densities of IL-17-producing cells and IFN-γ-producing cells were associated with overall survival (OS, P = 0.001) and disease-free survival (DFS, P = 0.001) of patients with HCC. The ratio of Th17 to Th1 in HBV-related HCC was higher than in non-HBV-related HCC. A multivariate Cox analysis revealed that the Th17 to Th1 ratio was an independent prognostic factor for OS (HR = 2.651, P = 0.007) and DFS (HR = 2.456, P = 0.002).
  
  
  CONCLUSIONS
  HBV infections can lead to an imbalance in immune status in patients with HCC. An elevated Th17 to Th1 ratio may promote tumor progression. The Th17 to Th1 ratio could serve as a potential prognostic marker for scoring the severity of HCC.
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Liu
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Xiao
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Ning-Lei
authors.initials: NL
authors.lastname: Li
authors.affiliation: Guangdong Provincial Key Laboratory of Liver Disease Research, Guangzhou, China; Department of Hepatic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Yi-Nan
authors.initials: YN
authors.lastname: Deng
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Lu-Zhe
authors.initials: LZ
authors.lastname: Han
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Liang-Chun
authors.initials: LC
authors.lastname: Yin
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Ling
authors.affiliation: Department of General Surgery, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Li-Xin
authors.initials: LX
authors.lastname: Liu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000276:immunology* / Q000401:mortality / Q000821:virology; D016022:Case-Control Studies; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology* / Q000401:mortality / Q000821:virology; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D020381:Interleukin-17 / Q000276:immunology* / Q000378:metabolism; D008113:Liver Neoplasms / Q000276:immunology* / Q000401:mortality / Q000821:virology; D011379:Prognosis; D015996:Survival Rate; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology*; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology*; D058504:Th17 Cells / Q000276:immunology*
chemical_list: D016207:Cytokines; D020381:Interleukin-17