Department of Clinical Pathology, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Department of Internal medicine, Faculty of Medicine (for Girls), Al-Azhar University, Cairo, Egypt.
Egypt J Immunol. 2022 Oct;29(4):33-45.
Hepatocellular carcinoma (HCC) is assumed to be an immunogenic malignancy since 90% of cases develop in environments with ongoing inflammation. Monocyte subsets contribute to tumoral immunity. Most HCC patients are discovered at late stages, which lowers their survival chances. We aimed to determine whether altered frequency of monocyte subsets contribute to post hepatitis C virus infection-liver cirrhosis (HCV-LC) development to HCC. This cross-sectional study enrolled 105 patients classified as post HCV-HCC (n=72) and post HCV-LC (n=33) patients. The monocyte subsets frequency was assessed by flow-cytometry. There was a significant increase in intermediate monocytes and decrease in non-classical monocytes in HCC group when compared to the LC group (P = 0.001 and 0.006, respectively). Intermediate monocyte frequency was positively correlated with cholesterol and triglycerides (r = 0.296, P < 0.002 and r = 0.247, P < 0.011, respectively). The receiver operating characteristic (ROC) curve revealed that intermediate monocytes percentage at a cutoff ≥ 0.625% and non-classical monocytes percentage at a cutoff ≤ 0.61% differentiated between patients with HCV-LC and those with HCV-HCC with a sensitivity of 76.4% and 69.4%, respectively, while both revealed low specificity of 51.5%. According to logistic regression analysis, only the triglyceride level was found to be an independent risk factor for HCC development [OR =1.014 (11.001-1.026), P = 0.031]. Finally, we concluded that post-HCV-HCC is characterized by an upregulation of intermediate monocytes and a downregulation of non-classical monocytes when compared to Post-HCV-LC. Intermediate and non-classical monocytes frequency can aid to screening biomarkers for HCC development. Intermediate monocyte frequency may be linked to hyperlipemia. The level of triglycerides is proposed as an independent risk factor for HCC emergence.
肝细胞癌（HCC）被认为是一种免疫原性恶性肿瘤，因为 90%的病例发生在持续炎症的环境中。单核细胞亚群有助于肿瘤免疫。大多数 HCC 患者在晚期被发现，这降低了他们的生存机会。我们旨在确定单核细胞亚群频率的改变是否有助于丙型肝炎病毒感染后肝硬化（HCV-LC）向 HCC 的发展。这项横断面研究纳入了 105 名患者，分为丙型肝炎后 HCC（n=72）和丙型肝炎后 LC（n=33）患者。通过流式细胞术评估单核细胞亚群频率。与 LC 组相比，HCC 组中间单核细胞显著增加，非经典单核细胞减少（P=0.001 和 0.006）。中间单核细胞频率与胆固醇和甘油三酯呈正相关（r=0.296，P<0.002 和 r=0.247，P<0.011）。ROC 曲线显示，中间单核细胞百分比≥0.625%和非经典单核细胞百分比≤0.61%可区分 HCV-LC 和 HCV-HCC 患者，其敏感性分别为 76.4%和 69.4%，特异性均较低，为 51.5%。根据逻辑回归分析，只有甘油三酯水平被发现是 HCC 发展的独立危险因素[OR=1.014（11.001-1.026），P=0.031]。最后，我们得出结论，与 HCV-LC 相比，HCV-HCC 后中间单核细胞上调，非经典单核细胞下调。中间和非经典单核细胞频率可以辅助筛选 HCC 发展的生物标志物。中间单核细胞频率可能与高脂血症有关。甘油三酯水平被提出作为 HCC 发生的独立危险因素。
