Zhao Hong-Qiang, Li Wei-Min, Lu Zhong-Qiou, Yao Yong-Ming
Hong-Qiang Zhao, Medical School of Chinese People's Liberation Army, Beijing 100853, China.
World J Gastroenterol. 2014 Jun 28;20(24):7971-8. doi: 10.3748/wjg.v20.i24.7971.
To assess systematically the association between regulatory T cells (Tregs) and hepatocellular carcinoma (HCC).
We searched Medline, Embase and Wanfang databases for literature on the populations of Tregs in HCC patients and controls, using the pooled OR and 95%CIs for assessment. There were no limitations with respect to publication date or language. The references of qualifying articles were also searched. We excluded studies with unclear data or overlapping studies. Twenty-three studies met our criteria, and the quality of these studies was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). The meta-analysis of association between Tregs and HCC was undertaken using the random-effects approach, as described by DerSimonian and Laird. Subgroup analysis was performed when at least three studies were available. Potential publication bias was assessed by visual inspection of the funnel plot, and an asymmetric plot suggested possible publication bias.
Twenty-three studies with a total of 1279 HCC patients and 547 healthy volunteers as controls were enrolled. The frequency of circulating Tregs in HCC patients was 87% higher than in healthy controls (OR = 1.87, 95%CI: 1.49-2.34). The frequency of Tregs in the HCC tumor microenvironment was significantly higher than that in tumor-surrounding tissue and biopsy specimens from healthy livers (OR = 4.04, 95%CI: 2.10-7.79, P = 0.000; OR = 2.869, 95%CI: 2.16-3.82, P = 0.000). However, subgroup analyses based on the different types of tumors or patient characteristics such as tumor size, tumor number or α fetoprotein (AFP) levels in HCC patients, showed that populations of Tregs as a whole were not significantly changed between groups (P > 0.05 for all).
There is an obvious association between Tregs and pathogenesis of HCC. Further well-designed clinical studies are warranted to illustrate the potential role of Tregs in HCC.
系统评估调节性T细胞（Tregs）与肝细胞癌（HCC）之间的关联。
我们检索了Medline、Embase和万方数据库，以查找有关HCC患者和对照中Tregs群体的文献，使用合并的OR和95%置信区间进行评估。对发表日期或语言没有限制。还检索了符合条件文章的参考文献。我们排除了数据不明确的研究或重复研究。23项研究符合我们的标准，并使用苏格兰校际指南网络（SIGN）对这些研究的质量进行了评估。采用DerSimonian和Laird描述的随机效应方法对Tregs与HCC之间的关联进行荟萃分析。当有至少三项研究时进行亚组分析。通过漏斗图的可视化检查评估潜在的发表偏倚，不对称图表明可能存在发表偏倚。
纳入了23项研究，共1279例HCC患者和547名健康志愿者作为对照。HCC患者循环Tregs的频率比健康对照高87%（OR = 1.87，95%CI：1.49 - 2.34）。HCC肿瘤微环境中Tregs的频率显著高于肿瘤周围组织和健康肝脏活检标本中的频率（OR = 4.04，95%CI：2.10 - 7.79，P = 0.000；OR = 2.869，95%CI：2.16 - 3.82，P = 0.000）。然而，基于不同类型肿瘤或患者特征（如HCC患者的肿瘤大小、肿瘤数量或甲胎蛋白（AFP）水平）的亚组分析表明，各组之间Tregs群体总体上没有显著变化（所有P>0.05）。
Tregs与HCC发病机制之间存在明显关联。有必要开展进一步设计良好的临床研究，以阐明Tregs在HCC中的潜在作用。
