Th17/Treg imbalance is an indicator of liver cirrhosis process and a risk factor for HCC occurrence in HBV patients.
OBJECTIVE
To determine the impact of T helper 17 cell (Th17)/regulatory T cell (Treg) ratio imbalance on the process and prognosis of hepatitis B virus (HBV)-related liver cirrhosis.


METHODS
Patients with HBV who refused to accept any therapy from were recruited from 2009 to 2014 and followed-up to August 2016. Based on a liver stiffness measurement (LSM), the patients were divided into a low LSM group and a high LSM group. After propensity score matching, 150 patients were included. The peripheral blood of all subjects was tested using a flow cytometer to measure the Th17 and Treg cell frequencies and the Th17/Treg ratio. Spearman rank correlation, log-rank test, Cox regression model, and receiver operating characteristic (ROC) curves were applied to analyze the correlation between the Th17/Treg ratio and LSM level and the risk factors of HCC occurrence and to predict the Th17/Treg ratio for the LSM level.


RESULTS
Th17 and Treg cell frequencies and the Th17/Treg ratio were significantly different between the low and high LSM groups. The Th17/Treg ratio showed a strong positive association with LSM level (r=0.631, P<0.01). Furthermore, the Th17/Treg ratio was an independent factor influencing the HCC occurrence, which was tested using a Cox regression model. The area under the ROC curve of the Th17/Treg ratio for predicting LSM level was 0.783 (95% CI 0.705-0.861).


CONCLUSIONS
Th17/Treg ratio imbalance is an indicator of the liver cirrhosis process and a risk factor for HCC occurrence in patients infected with HBV.
Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan 430071, PR China.
Kun
K
Li
Department of Infectious Disease, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, PR China.
Huaie
H
Liu
Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan 430071, PR China. Electronic address: guotaosci@126.com.
Tao
T
Guo
D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications*; D008113:Liver Neoplasms / Q000209:etiology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D050378:T-Lymphocytes, Regulatory; D058504:Th17 Cells