Foxp3+ regulatory T cells are associated with the natural history of chronic hepatitis B and poor prognosis of hepatocellular carcinoma
Article first published online: 28 NOV 2011
© 2011 John Wiley & Sons A/S
Volume 32, Issue 4, pages 644–655, April 2012
How to Cite
Wang, F., Jing, X., Li, G., Wang, T., Yang, B., Zhu, Z., Gao, Y., Zhang, Q., Yang, Y., Wang, Y., Wang, P. and Du, Z. (2012), Foxp3+ regulatory T cells are associated with the natural history of chronic hepatitis B and poor prognosis of hepatocellular carcinoma. Liver International, 32: 644–655. doi: 10.1111/j.1478-3231.2011.02675.x
- Issue published online: 8 MAR 2012
- Article first published online: 28 NOV 2011
- Manuscript Accepted: 13 OCT 2011
- Manuscript Received: 15 JUN 2011
- Tianjin Science
- Technology commission. Grant Number: 05YFSZSF02500
- Tianjin Health Bureau. Grant Number: 05KYZ13
- hepatitis B viruses;
- hepatocellular carcinoma;
- regulatory T cells
Recent studies have focused on regulatory T cells (Tregs) in chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC) and they were also conducted independently of each other.
This study tried to characterize Tregs in blood and tumour infiltration, and to explore the correlations between Tregs and the context of chronic hepatitis B in HCC patients.
The liver-resident Tregs and CD8+ T cells on core biopsy were investigated using immunohistochemistry staining in individuals (n = 209) with CHB (n = 47), HCC (n = 137) or healthy controls (n = 25). Circulating Tregs were detected in the above patients with CHB (n = 27) or HCC (n = 101) by flow cytometry.
The number of tumour-infiltrating and circulating FoxP3+ Tregs was significantly high in patients with CHB (P < 0.001). However, there were fewer intratumoural Tregs in patients with advanced HCC than those in patients with early stage HCC (P = 0.043); In contrast, the circulating Tregs frequency increased during the progression of HCC (P = 0.024). Increased tumour-infiltrating and circulating FoxP3+ Tregs were associated with poor overall survival (P = 0.041, 0.002 respectively) and a shorter time to recurrence (P = 0.049, 0.002 respectively) in patients with early stage HCC. Tumour-infiltrating Foxp3 + Tregs were related to chronic hepatitis B natural history in HCC (P = 0.012). Neither tumour-infiltrating CD8+ T cells nor balance of intratumoural Tregs and CD8+ T cells correlated with prognosis of HCC.
Increased Foxp3+ Tregs may represent a prognostic predictor in patients with early stage HCC. The CHB natural history influenced density of tumour-infiltrating Tregs in hepatocellular carcinoma patients with chronic hepatitis B viruses infection.