Prognostic Significance Of T Helper Cell 17 In Hepatocellular Carcinoma

Hepatocellular carcinoma(HCC) is one of the malignant tumors which threatens human’s health seriously. The incidence and mortality of HCC increased year by year, and the mortality was in the second highest place in a variety of malignant tumors in the world. High recurrence rate and high metastasis rate are closely related with high mortality. There is an urgent need to clarify the molecular mechanism of HCC in recurrence and metastasis, predict accurately the prognosis of patients, and find the effective targets and new methods to design reasonable intervention. The traditional HCC researches focus on tumor cells themselves, and try to explain the recurrence and metastasis of the tumor from the genetic and phenotypic changes of cancer cells. Recent studies are paying more attention to the important role of local tumor micro-environment in the evolution of the tumor. Chronic hepatitis caused by persistent hepatitis virus(HBV, HCV) infection devotes to liver cell necrosis and regeneration repeatedly, so as to start the regenerative nodules of hepatocytes to atypical hyperplasia process so that the occurrence of liver cancer.Therefore, chronic inflammation response of the liver is critical to liver cancer.Lymphocytes are the subject of the body’s immune response. In recent years, it has been found that T helper cell 17(Th17) with pro-inflammatory effects involve in the development process of a variety of inflammatory, autoimmune diseases and tumors.Multiple research have shown that Th17 cells promote the growth, infiltration and metastasis of HCC, and associated with poor prognosis of patients with HCC. This study aims to apply Meta analysis to analyze the previous research results synthetically and quantitatively and evaluate the prognostic significance of Th17 in HCC.Objective To explore the prognostic significance of Th17 cells in hepatocellular carcinoma performed the research method of evidence-based medicine--Meta analysis.Methods A comprehensive search of Pub Med, Cochrane library, Web of Science databases, Wan-Fang database, China National Knowledge Infrastructure(CNKI),and VIP network was done from 2009 to 2015. Screen case-control studies about the prognostic significance of Th17 cells in HCC according to inclusion criteria and exclusion criteria. And collect HCC patients’ survival curves to extract the data of survival rates and recurrence rates. The extracted data were analyzed by Rev Man5.3software. We calculated the odds ratio(OR) and 95% confidence interval(CI) of postoperative survival rates and recurrence rates of HCC patients at 1 year, 3 years and 5 years with fixed effect model or random effect model. Funnel plots were used to identify the publication bias and forest plots to analyze the prognostic significance of Th17 cells in HCC.Results1. Postoperative survival rates in HCC patients with high level of Th17 cells were well lower than that with low level of Th17 cells at 1 year [OR=0.37, 95%CI(0.25,0.56), P<0.00001], 3 years [OR=0.26, 95%CI(0.14,0.45), P<0.00001] and 5years [OR=0.25, 95%CI(0.12,0.50), P=0.0001] and the statistical analysis showed significant difference.2. postoperative recurrence rates in HCC patients with high level of Th17 cells were well higher than that with low level of Th17 cells at 1 year [OR=3.34, 95%CI(2.57,4.35), P<0.00001], 3 years [OR=2.15, 95%CI(1.65,2.80), P<0.00001] and 5 years [OR=2.47, 95%CI(1.09,5.59), P=0.03] and the statistical analysis showed significant difference.Conclusions Meta analysis showed that high level of Th17 cells indicated poor prognosis of postoperative patients with HCC.