Th17/Treg imbalance is an indicator of liver cirrhosis process and a risk factor for HCC occurrence in HBV patients - 04/02/17

Doi : 10.1016/j.clinre.2016.12.004

Kun Li ^a,^{^{1
Both authors contributed equally to this work.}}, Huaie Liu ^b,^{^{1
Both authors contributed equally to this work.}}, Tao Guo ^a,^⁎
^a Department of General Surgery, Research Center of Digestive Diseases, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan 430071, PR China
^b Department of Infectious Disease, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, PR China

^⁎Corresponding author.

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Summary

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).