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Authors Abeer Attia Saad 1 , MD, Heba Mohamed Abdella 2 , MD, Doaa G Eissa 1 , MD, Marwa G. A Hegazy 3 , PhD, Amal Farouk 1 , MD, Marcel William Keddeas 4 , MD, Nahla Fawzy Abouelezz 5 , MD, Ahmed Kamal Eldorry 6 , MD, Mohamed Kamal Shaker 2 , MD 1 Dept of Clinical Pathology, 2 Tropical Medicine, 3 Biochemistry Dept, 4 Internal Medicine, 5 Community, Environmental and Occupational Medicine, 6 Interventional Radiology; Faculty of Medicine and; Faculty of Science, Ain Shams University, Cairo, Egypt Corresponding Author Dr Doaa Gamal Eissa Dept of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt, PO: 11381. Fax and E-mail: doaaeissa3@yahoo.com Fax/Telephone Number: +2024824073 Abstract Background: T-regs play a role in suppression of the tumor immune response, including hepatocellular carcinoma (HCC). We studied circulating T-regs in non-metastatic HCC patients related to hepatitis C virus (HCV) cirrhosis by comparing and correlating levels in different stages of the disease with survival and various clinico-pathologic features. Methods: 76 non-metastasizing HCC patients and 76 healthy volunteers were assessed for circulating Tregs using flow cytometry in addition to complete blood picture, liver function test, alpha fetoprotein (AFP). Results: Patients showed higher T-regs% and T-effs% than controls (P<0.001) with lower absolute number of both cells in patients (P= 0.001, 0.002 respectively). No significant differences were found between stage A and stage B patients (P> 0.05). The absolute numbers of both T-regs and T-effs cells were significantly higher in patients with tumor size of the largest nodule more than 3 cm (P= 0.02, 0.008 respectively). T-regs% was significantly higher in patients with higher serum AFP levels and multiple tumor foci (P= 0.004, 0.02 respectively). Patients with higher T-regs% had significantly shorter overall mean survival time (p=0.003). Conclusions: HCC showed increased peripheral blood T-regs more in patients with larger tumor sizes, multiple tumor foci and higher serum AFP, and was linked to shorter overall mean survival time.

Circulating CD4+CD25highFoxP3+ T Cells in Non- metastatic Hepatocellular Carcinoma Related to Hepatitis C Virus Cirrhosis