Department of Internal Medicine, Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Hepatol Int. 2020 Mar;14(2):249-258. doi: 10.1007/s12072-020-10014-4. Epub 2020 Feb 18.
Regulatory T cell (Treg) plays an essential role in regulating anti-tumor immunity. The aim of this study was to investigate the effect of transarterial chemoembolization (TACE) on Treg in hepatocellular carcinoma (HCC) patients.
The frequency of peripheral blood Tregs in 27 HCC patients who underwent TACE were measured at baseline and 1 month after TACE. The frequency of peripheral blood Tregs at baseline were compared with those in 23 healthy controls. Tregs were further classified into three subpopulations [Treg (I), Treg (II), Treg (III)] based on expression levels or markers and their function. The patients were divided into two groups according to tumor response after TACE; complete response group and incomplete response group. The correlations between the frequency of Treg and clinical factors were analyzed.
The frequency of Treg in HCC patients (7.52%) was significantly higher than in healthy controls (4.99%) at baseline. Regarding Treg subpopulations, the frequency of Treg (II) was significantly higher in HCC patients (2.51%) than in healthy controls (0.60%). In comparison of Treg numbers at baseline and post-TACE by tumor response, the change of Treg (III) in complete response group from baseline to post-TACE was significantly decreased (63.8 → 53.2/mm). Patients with a high post-TACE Treg (III) (3.8 months) exhibited a significantly shorter median time to progression than those with a low post-TACE Treg (III) (11.6 months). In multivariate analyses, hypoalbuminemia (hazard ratio 3.324; 95% CI 1.098-10.063, p = 0.034) and high post-TACE Treg (III) (hazard ratio 3.080; 95% CI 1.091-8.696, p = 0.034) were significant factors for associating with progression.
The frequency of Tregs in HCC patients was significantly higher than in healthy controls. In addition, patients with a high post-TACE Treg (III) exhibited a significantly lower progression-free survival rate than those with a low post-TACE Treg (III).
调节性 T 细胞（Treg）在调节抗肿瘤免疫中起着至关重要的作用。本研究旨在探讨经动脉化疗栓塞（TACE）对肝细胞癌（HCC）患者 Treg 的影响。
在 TACE 前和 TACE 后 1 个月测量 27 例 HCC 患者外周血 Treg 的频率。将 TACE 前的外周血 Treg 频率与 23 例健康对照者进行比较。根据表达水平或标志物和功能将 Tregs进一步分为三个亚群[Treg（I）、Treg（II）、Treg（III）]。根据 TACE 后肿瘤的反应将患者分为完全缓解组和不完全缓解组。分析 Treg 频率与临床因素的相关性。
HCC 患者（7.52%）Treg 的频率明显高于健康对照组（4.99%）。在 Treg 亚群方面，HCC 患者 Treg（II）的频率（2.51%）明显高于健康对照组（0.60%）。比较肿瘤反应前后 Treg 数量的变化，完全缓解组 Treg（III）从基线到 TACE 后下降（63.8→53.2/mm）。TACE 后 Treg（III）高的患者（3.8 个月）与 TACE 后 Treg（III）低的患者（11.6 个月）相比，中位无进展生存期明显缩短。多变量分析显示，低白蛋白血症（危险比 3.324；95%CI 1.098-10.063，p=0.034）和 TACE 后 Treg（III）高（危险比 3.080；95%CI 1.091-8.696，p=0.034）是与进展相关的显著因素。
HCC 患者 Tregs 的频率明显高于健康对照组。此外，TACE 后 Treg（III）高的患者无进展生存率明显低于 TACE 后 Treg（III）低的患者。
