Expression And Prognostic Value Of M2 Macrophages In Hepatocellular Carcinoma

Background and ObiectivesHepatocellular carcinoma(HCC)is the fifth most common malignant tumor and one of the common causes of malignant tumor death in the world.Over 500,000 new cases and deaths are estimated to occur every year.HCC is characterized by rapid disease progression with high postsurgical recurrence and high metastatic rate(50%to 70%over five years),which often results in poor clinical outcomes.Nowadays many achievements,such as surgery,interventional therapy,radiofrequency ablation and other treatment methods,have been made in the academic and clinical research of HCC and have benefited many patients.But due to the onset of HCC is hidden and the early symptoms are not obvious,advanced HCC patients are more common and the number of cases is gradually increasing.Most of these patients are accompanied by distant metastasis,and the prognosis is very poor.At the same time,recurrence after operation is also a great challenge to the treatment of HCC.Therefore,the search for more potential biomarkers will help to improve the diagnosis and prediction of HCC.Studies have found that inflammation plays an important role in tumorigenesis and development,with about 20%of cancers associated with chronic infections.Chronic inflammation has been associated with an increase in the incidence of malignant tumors for a long time,and there are also similarities in regulatory mechanisms.Natural immune cells include macrophages and neutrophils,which promote the development of tumors through a variety of mechanisms.Some studies have shown that the development of liver cancer requires the interference between tumor cells and the surrounding microenvironment.Tumor microenvironment refers to the local microenvironment which is composed of interstitial cells,immune cells and secreted active media.Tumor microenvironment plays an important role in the regulation of liver fibrosis,liver cancer,epithelial mesenchyma metastasis,tumor invasion and metastasis.Tumor associated macrophage(TAM)is the main component of tumor microenvironment and plays an important role in promoting and maintaining tumor progress.Macrophages,as the key mediators of inflammatory response,are generally polarized into two main daughter cells:classic activated macrophages(M1)and alternating activated macrophages(M2),in which the latter are thought to promote tumor angiogenesis,progress and metastasis.CD206 and CD 163 are phenotypic markers of M2 macrophages,but the expression of CD 163 and CD206 in primary liver cancer and their relationship with prognosis are not clear.In this study,the expression of CD206,CD 163 in hepatocellular carcinoma(HCC)was detected to explore the value of CD206 and CD 163 in predicting the occurrence,development and prognosis of HCC.Materials and MethodsA retrospective analysis of 51 patients with liver cancer who underwent surgical treatment,conventional formalin fixation,paraffin-embedded and pathological diagnosis from May 2012 to May 2016.Collect medical history and obtain complete clinical data including sex,age,etiology,laboratory examination,Child-Pugh classification,tumor stage and so on.Immunohistochemical methods was used to detect the expression of CD206,CD 163 in the specimen.Fifty-one cases of HCC patients were followed up.SPSS 24.0 and MedCalc18.5.0 software were used for data analysis.Results1.The positive staining of CD 206 was mainly located in the membrane of macrophages,and the positive staining of CD 163 was mainly located in the cytoplasm of macrophages.The number of CD 163 positive cells was higher than that of CD 206 positive cells in tumor tissues,.The difference was statistically significant(P<0.05).2.The number of CD206 positive cells was significantly correlated with serum AST,and the number of CD 163 positive cells was significantly correlated with the number of nodules,sex and serum TBil in cancer tissues(P<0.05).3.The overall survival time and recurrence-free survival time of CD206,CD 163 in high expression group were significantly shorter than those of low expression group.The difference was statistically significant(P<0.05).4.CD206 and CD 163 expression levels were independent prognostic factors in HCC patients(P<0.05).Conclusions1.CD206 and CD163TAMs are closely related to hepatocarcinogenesis,and high expression is associated with shorter survival in HCC patients.2.The high expression of CD206 and CD163TAMs in HCC tissues is closely related to the shortening of OS?RFS,which indicating that CD206 and CD 163 may become indicators to judge the prognosis after HCC operation.