Key Word(s): 1 gastric

cancer; 2 serum proteomics; 3 i

Key Word(s): 1. gastric

cancer; 2. serum proteomics; 3. iTRAQ; 4. D-LC-MS/MS; Presenting Author: MALU JUN Additional Authors: LINYAO GUANG Corresponding Author: LINYAO GUANG Affiliations: guangxi medical university Objective: To study the expression of S100A11 and Beclin1 in gastric carcinoma, precancerous lesion and chronic nonatrophic pangastritis, and the relationship between S100A11 and Beclin1 expression in gastric cancerous tissues and the biological behaviour of gastric carcinoma, investigate the mechanism and clinical significance of S100A11 and Beclin1 RG7420 cost in the development of gastric carcinoma. Methods: The expression of S100A11 and Beclin1 proteins were determined by streptavidin-perosidase immunohistochemical method in 50 cases of gastric carcinoma from exairesis tissues, 30 cases of precancerous lesion and 20 cases of chronic nonatrophic pangastritis from endoscopic biopsy. Pathological image analysis system be used to analysis the grey level of S100A11 and Beclin1, then analyze the mechanism and clinical significance of S100A11 and Beclin1 in the development of gastric carcinoma.

Results: The positive expression grey level of S100A11 in gastric carcinoma was 132.9209 ± 5.649, and in precancerous lesion tissues was 133.6706 ± 5.8348, both of them were significantly lower than that of in chronic nonatrophic medchemexpress pangastritis tissues (138.048 ± 3.5902), see more There were significant difference between the gastric carcinoma and chronic nonatrophic pangastritis tissues, precancerous lesion tissues and chronic nonatrophic pangastritis tissues (P < 0.05), But there was no difference between the gastric carcinoma and precancerous lesion tissues (P > 0.05). There was obvious correlation between the expression of S100A11 and the clinicopathological

factors, such as grading, infiltrating depth, lymph nodes metastasis, TNM degree (P < 0.05), but there was no correlation between the expression of S100A11 and position, knubbly diameter (P > 0.05). The positive expression grey level of Beclin1 in gastric carcinoma was 140.9705 ± 6.2019, which was significantly higher than those in precancerous lesion tissues (136.711 ± 5.5759) and in chronic nonatrophic pangastritis tissues (130.8024 ± 2.5363), there were significantly differences between two of the three tissues (P < 0.05). There was correlation between the expression of Beclin1 and grading, lymph nodes metastasis (P < 0.05), but there was no correlation between the expression of Beclin1 and position, diameter, infiltrating depth, TNM degree (P > 0.05), There existed a negative correlation between S100A11 and Beclin1 in gastric carcinoma (r = −0.156, P < 0.05).

Each reaction contained 5 μL of diluted cDNA, 500 nM of each prim

Each reaction contained 5 μL of diluted cDNA, 500 nM of each primer (as listed in Supporting Table 1), and 1× LightCyclerR 480 SYBR Green I master mix. The real-time PCR running protocol consisted of (1) 5-minute preincubation at 95°C, (2) amplification (10 seconds at 95°C, 10 seconds at 60°C, and 15 seconds at 72°C), (3) melting curve (10 seconds at 95°C, 65°C-97°C at at 2.5°C/s−1, and a continuous fluorescent measurement), and (4) 10 seconds of cooling at 40°C. Relative quantitative analysis

was carried out according to the 2−ΔΔCt method.[23] Descriptive characteristics of genetic and clinical variables were reported selleck chemicals llc as frequencies and percentages for categorical variables; continuous variable were reported as medians and range. Comparisons of frequencies between genetic and clinical variables were performed using chi-square and Fisher’s exact tests, where appropriate. Survival analyses were performed using Kaplan-Meier’s method. Univariate survival analysis was performed using log-rank tests, and multivariate analyses were conducted using Cox’s proportional hazards model. Complete clinical data were available for 87 of 89 (98%) tumor samples and is shown in Table 1. Cases included a mix of predisposing disease etiologies, including

43% and 21% of patients with hepatitis B and C, respectively. Nineteen cases had multifocal disease at time of surgery; however, www.selleckchem.com/products/Etopophos.html only one tumor was submitted for medchemexpress analysis in each case. Positive staining for cytokeratin 19 (CK19) in >5% of cells was noted in 12 cases, and two tumors were fibrolamellar HCC. Median follow-up of cases was 33.8 months (range, 3-130). There were 3 (3.8%) perioperative deaths within 90 days. A total of 28 of 87 (32%) patients died, with a mean overall survival (OS) of 80.6 months with a 5-year overall survival estimated at 76% by Kaplan-Meier’s analysis. During follow-up, there were a total

of 44 recurrences for a median disease-free survival (DFS) of 39.1 months. In total, we found 5,820 nonsynonymous mutations and 433 nonsense mutations in these 87 tumors (average, 66.1; range, 4-362) or 2.5 mutations per Mb sequenced (Fig. 1A). The somatic mutation rate is comparable to those reported in previous studies.[11-14] The mutational bias for CpG to A/T transversions in HCC was consistent with previous studies (Fig. 1B). We followed standard statistical analyses to discriminate driver mutations from random mutations.[19, 24] We assumed that most of the mutations in cancer genomes represent background noise, whereas driver genes would be mutated more frequently than expected by chance. We used a binomial probability to estimate the expected number of mutations for each sample. This probability distribution corrects for gene length because of the assumption that longer genes will be expected to accumulate more mutations by chance.

Each reaction contained 5 μL of diluted cDNA, 500 nM of each prim

Each reaction contained 5 μL of diluted cDNA, 500 nM of each primer (as listed in Supporting Table 1), and 1× LightCyclerR 480 SYBR Green I master mix. The real-time PCR running protocol consisted of (1) 5-minute preincubation at 95°C, (2) amplification (10 seconds at 95°C, 10 seconds at 60°C, and 15 seconds at 72°C), (3) melting curve (10 seconds at 95°C, 65°C-97°C at at 2.5°C/s−1, and a continuous fluorescent measurement), and (4) 10 seconds of cooling at 40°C. Relative quantitative analysis

was carried out according to the 2−ΔΔCt method.[23] Descriptive characteristics of genetic and clinical variables were reported this website as frequencies and percentages for categorical variables; continuous variable were reported as medians and range. Comparisons of frequencies between genetic and clinical variables were performed using chi-square and Fisher’s exact tests, where appropriate. Survival analyses were performed using Kaplan-Meier’s method. Univariate survival analysis was performed using log-rank tests, and multivariate analyses were conducted using Cox’s proportional hazards model. Complete clinical data were available for 87 of 89 (98%) tumor samples and is shown in Table 1. Cases included a mix of predisposing disease etiologies, including

43% and 21% of patients with hepatitis B and C, respectively. Nineteen cases had multifocal disease at time of surgery; however, Nutlin-3 mouse only one tumor was submitted for medchemexpress analysis in each case. Positive staining for cytokeratin 19 (CK19) in >5% of cells was noted in 12 cases, and two tumors were fibrolamellar HCC. Median follow-up of cases was 33.8 months (range, 3-130). There were 3 (3.8%) perioperative deaths within 90 days. A total of 28 of 87 (32%) patients died, with a mean overall survival (OS) of 80.6 months with a 5-year overall survival estimated at 76% by Kaplan-Meier’s analysis. During follow-up, there were a total

of 44 recurrences for a median disease-free survival (DFS) of 39.1 months. In total, we found 5,820 nonsynonymous mutations and 433 nonsense mutations in these 87 tumors (average, 66.1; range, 4-362) or 2.5 mutations per Mb sequenced (Fig. 1A). The somatic mutation rate is comparable to those reported in previous studies.[11-14] The mutational bias for CpG to A/T transversions in HCC was consistent with previous studies (Fig. 1B). We followed standard statistical analyses to discriminate driver mutations from random mutations.[19, 24] We assumed that most of the mutations in cancer genomes represent background noise, whereas driver genes would be mutated more frequently than expected by chance. We used a binomial probability to estimate the expected number of mutations for each sample. This probability distribution corrects for gene length because of the assumption that longer genes will be expected to accumulate more mutations by chance.

Each reaction contained 5 μL of diluted cDNA, 500 nM of each prim

Each reaction contained 5 μL of diluted cDNA, 500 nM of each primer (as listed in Supporting Table 1), and 1× LightCyclerR 480 SYBR Green I master mix. The real-time PCR running protocol consisted of (1) 5-minute preincubation at 95°C, (2) amplification (10 seconds at 95°C, 10 seconds at 60°C, and 15 seconds at 72°C), (3) melting curve (10 seconds at 95°C, 65°C-97°C at at 2.5°C/s−1, and a continuous fluorescent measurement), and (4) 10 seconds of cooling at 40°C. Relative quantitative analysis

was carried out according to the 2−ΔΔCt method.[23] Descriptive characteristics of genetic and clinical variables were reported selleck inhibitor as frequencies and percentages for categorical variables; continuous variable were reported as medians and range. Comparisons of frequencies between genetic and clinical variables were performed using chi-square and Fisher’s exact tests, where appropriate. Survival analyses were performed using Kaplan-Meier’s method. Univariate survival analysis was performed using log-rank tests, and multivariate analyses were conducted using Cox’s proportional hazards model. Complete clinical data were available for 87 of 89 (98%) tumor samples and is shown in Table 1. Cases included a mix of predisposing disease etiologies, including

43% and 21% of patients with hepatitis B and C, respectively. Nineteen cases had multifocal disease at time of surgery; however, ABT-263 only one tumor was submitted for 上海皓元医药股份有限公司 analysis in each case. Positive staining for cytokeratin 19 (CK19) in >5% of cells was noted in 12 cases, and two tumors were fibrolamellar HCC. Median follow-up of cases was 33.8 months (range, 3-130). There were 3 (3.8%) perioperative deaths within 90 days. A total of 28 of 87 (32%) patients died, with a mean overall survival (OS) of 80.6 months with a 5-year overall survival estimated at 76% by Kaplan-Meier’s analysis. During follow-up, there were a total

of 44 recurrences for a median disease-free survival (DFS) of 39.1 months. In total, we found 5,820 nonsynonymous mutations and 433 nonsense mutations in these 87 tumors (average, 66.1; range, 4-362) or 2.5 mutations per Mb sequenced (Fig. 1A). The somatic mutation rate is comparable to those reported in previous studies.[11-14] The mutational bias for CpG to A/T transversions in HCC was consistent with previous studies (Fig. 1B). We followed standard statistical analyses to discriminate driver mutations from random mutations.[19, 24] We assumed that most of the mutations in cancer genomes represent background noise, whereas driver genes would be mutated more frequently than expected by chance. We used a binomial probability to estimate the expected number of mutations for each sample. This probability distribution corrects for gene length because of the assumption that longer genes will be expected to accumulate more mutations by chance.

Regardless of the mechanism of the first step, subsequent less dr

Regardless of the mechanism of the first step, subsequent less drug-specific downstream processes determine whether initial injury proceeds to MPT, and thereafter to apoptosis or necrosis. These processes involve cytokines, caspases, antioxidant defense, and secondary immune reactions to form a system with complex regulation. Genetic and environmental downstream risk factors can impair protective or enhance injurious parts of this system,

and tip its fine-tuned balance; further amplification mechanisms may then lead to acute DILI.7, 11, 15 The important role of the right balance in the cytokine system for unspecific PD0325901 cost downstream mechanisms of DILI is also suggested by models of intrinsic hepatotoxicity where an increased

susceptibility to acetaminophen and high serum levels of the proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis Selleckchem PF-2341066 factor alpha (TNF-alpha) and interferon gamma were observed in IL-10/IL-4 double knockout mice.16 Although environmental risk factors of DILI are not the focus of this review, their relevance for the identification of genetic risk factors merits attention. In the sense of a multicausal pie model of disease,17 environmental risk factors such as enzyme induction,18 alcohol,19, 20 or malnourishment21 could act as necessary triggers within a set of component causes for DILI. This would also be compatible with long latency times in some cases of DILI. Our ability to predict DILI therefore depends on the identification of both genetic and environmental risk factors. Although it is difficult to identify environmental risk factors for DILI and many therefore remain unknown, 上海皓元 detectable factors such as comorbidities,22-24 pharmacokinetic interactions with other drugs,25, 26 and dose27, 28 should be considered in association studies whenever possible. Mechanisms of DILI, related genetic as well as environmental risk factors, and a model for their (essentially unknown) interactive contribution to the development of DILI are summarized in Fig. 2. Taken together, the aspects discussed above provide a new

framework and have implications that also influenced the design of some recent genetic association studies of DILI: Complex multilevel mechanisms of DILI define additional targets for the identification of genetic risk factors.29-31 Genetic variants may affect the function as well as the transcriptional regulation of gene products that relate to hepatotoxic mechanisms.32 Genetic risk factors that relate to initial upstream mechanisms of injury may only lead to isolated mild to moderate increases of aminotransferases, which can therefore also be a suitable endpoint.14, 33 Genetic risk factors that affect hepatotoxic downstream mechanisms should in theory be less drug-specific and may therefore be identified in pooled cases of DILI caused by various drugs.

Regardless of the mechanism of the first step, subsequent less dr

Regardless of the mechanism of the first step, subsequent less drug-specific downstream processes determine whether initial injury proceeds to MPT, and thereafter to apoptosis or necrosis. These processes involve cytokines, caspases, antioxidant defense, and secondary immune reactions to form a system with complex regulation. Genetic and environmental downstream risk factors can impair protective or enhance injurious parts of this system,

and tip its fine-tuned balance; further amplification mechanisms may then lead to acute DILI.7, 11, 15 The important role of the right balance in the cytokine system for unspecific www.selleckchem.com/products/azd9291.html downstream mechanisms of DILI is also suggested by models of intrinsic hepatotoxicity where an increased

susceptibility to acetaminophen and high serum levels of the proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis Midostaurin price factor alpha (TNF-alpha) and interferon gamma were observed in IL-10/IL-4 double knockout mice.16 Although environmental risk factors of DILI are not the focus of this review, their relevance for the identification of genetic risk factors merits attention. In the sense of a multicausal pie model of disease,17 environmental risk factors such as enzyme induction,18 alcohol,19, 20 or malnourishment21 could act as necessary triggers within a set of component causes for DILI. This would also be compatible with long latency times in some cases of DILI. Our ability to predict DILI therefore depends on the identification of both genetic and environmental risk factors. Although it is difficult to identify environmental risk factors for DILI and many therefore remain unknown, MCE detectable factors such as comorbidities,22-24 pharmacokinetic interactions with other drugs,25, 26 and dose27, 28 should be considered in association studies whenever possible. Mechanisms of DILI, related genetic as well as environmental risk factors, and a model for their (essentially unknown) interactive contribution to the development of DILI are summarized in Fig. 2. Taken together, the aspects discussed above provide a new

framework and have implications that also influenced the design of some recent genetic association studies of DILI: Complex multilevel mechanisms of DILI define additional targets for the identification of genetic risk factors.29-31 Genetic variants may affect the function as well as the transcriptional regulation of gene products that relate to hepatotoxic mechanisms.32 Genetic risk factors that relate to initial upstream mechanisms of injury may only lead to isolated mild to moderate increases of aminotransferases, which can therefore also be a suitable endpoint.14, 33 Genetic risk factors that affect hepatotoxic downstream mechanisms should in theory be less drug-specific and may therefore be identified in pooled cases of DILI caused by various drugs.

Regardless of the mechanism of the first step, subsequent less dr

Regardless of the mechanism of the first step, subsequent less drug-specific downstream processes determine whether initial injury proceeds to MPT, and thereafter to apoptosis or necrosis. These processes involve cytokines, caspases, antioxidant defense, and secondary immune reactions to form a system with complex regulation. Genetic and environmental downstream risk factors can impair protective or enhance injurious parts of this system,

and tip its fine-tuned balance; further amplification mechanisms may then lead to acute DILI.7, 11, 15 The important role of the right balance in the cytokine system for unspecific see more downstream mechanisms of DILI is also suggested by models of intrinsic hepatotoxicity where an increased

susceptibility to acetaminophen and high serum levels of the proinflammatory cytokines interleukin-6 (IL-6), tumor necrosis www.selleckchem.com/products/gsk126.html factor alpha (TNF-alpha) and interferon gamma were observed in IL-10/IL-4 double knockout mice.16 Although environmental risk factors of DILI are not the focus of this review, their relevance for the identification of genetic risk factors merits attention. In the sense of a multicausal pie model of disease,17 environmental risk factors such as enzyme induction,18 alcohol,19, 20 or malnourishment21 could act as necessary triggers within a set of component causes for DILI. This would also be compatible with long latency times in some cases of DILI. Our ability to predict DILI therefore depends on the identification of both genetic and environmental risk factors. Although it is difficult to identify environmental risk factors for DILI and many therefore remain unknown, 上海皓元 detectable factors such as comorbidities,22-24 pharmacokinetic interactions with other drugs,25, 26 and dose27, 28 should be considered in association studies whenever possible. Mechanisms of DILI, related genetic as well as environmental risk factors, and a model for their (essentially unknown) interactive contribution to the development of DILI are summarized in Fig. 2. Taken together, the aspects discussed above provide a new

framework and have implications that also influenced the design of some recent genetic association studies of DILI: Complex multilevel mechanisms of DILI define additional targets for the identification of genetic risk factors.29-31 Genetic variants may affect the function as well as the transcriptional regulation of gene products that relate to hepatotoxic mechanisms.32 Genetic risk factors that relate to initial upstream mechanisms of injury may only lead to isolated mild to moderate increases of aminotransferases, which can therefore also be a suitable endpoint.14, 33 Genetic risk factors that affect hepatotoxic downstream mechanisms should in theory be less drug-specific and may therefore be identified in pooled cases of DILI caused by various drugs.

Given this, there is a clear need to dissect the functional capac

Given this, there is a clear need to dissect the functional capacity of HP0986 in different cellular environments. We therefore, sought to extend this study to another cell type to ascertain the role of HP0986 in altering the cytokine responses by human epithelial cells (AGS cell line) and to understand the underlying mechanism. We also explored if HP0986 selleck screening library is presented to humoral immune system. This study also analyzed the prevalence as well as expression of HP0986 in clinical isolates and gastric biopsies obtained from an ethnically complex setting such as Malaysia. We also describe the localization of HP0986 in human gastric epithelial cells and discuss its potential to undergo

a possible cytoplasmic-nuclear shuttling. The present study was approved by the Ethics committee of the University of Malaya Hospital, Kuala Lumpur, Malaysia. Written informed consents were obtained from the patients as per the University protocol. We screened more than 500 patients in the present study who underwent gastric endoscopy at the University of Malaya Hospital, Kaula Lumpur, Malaysia, during 2012–2013. In total, 110 adult patients were selected in this study, and these were the patients of Apoptosis inhibitor functional dyspepsia (n = 102) (93%) and peptic ulcer disease (n = 8) (7%), determined on the basis of 2 inclusion criteria: those who had no history of H. pylori eradication

therapy and those positive for rapid urease test. Functional dyspepsia was endoscopically and pathologically defined as H. pylori associated functional dyspepsia. Sixty out of 110 patients were from Indian ethnic group (mean age 48.5), 38 were of Chinese ancestry (mean age 59.7), and 12 were Malay (mean age 51.6). In all, 51% (n = 56) were males and 49% (n = 54) were females. In total, 10 patients were selected in this study module; these patients underwent gastric endoscopy at the University of Malaya Hospital, Kaula Lumpur, Malaysia during 上海皓元 2013. All the 10 patients had functional dyspepsia. Among these, 6 were from Chinese

ethnic group (mean age 51.7) and 4 were of Indian ethnic group (mean age 59.7). Individual gastric biopsy specimens were placed in sterile vials after a positive diagnosis of H. pylori infection and were stored at −80°C. Out of these patients, four gastric biopsy specimens each were collected from antrum/body. One biopsy was immediately processed for bacterial culture, one for histologic examination, and two for total RNA extraction. Biopsy material was stored in formalin for histopathology and frozen in liquid nitrogen and stored at −80°C for total RNA extraction. Gastric biopsies (n = 110) were processed for H. pylori culture by homogenization of the tissue. Homogenates were inoculated on blood agar (Oxoid, Thermo Scientific) containing 7% horse blood and incubated at 37°C under 10% CO2 for 5–7 days [22]. H. pylori growth was confirmed by microscopy and rapid urease test.

Further reinforcing the role of the immune system, individual SNP

Further reinforcing the role of the immune system, individual SNP analyses reveal that the MHC class II locus contains three variants (rs9267673, rs2647073, and rs3997872) strongly associated with HCC. MHC class II molecules present antigen to CD4+ (helper) T cells.31 The three SNPs may be associated with altered MHC class II proteins that result in an ineffective T-cell response. Interestingly, rs2647073 lies 3.4 kb from rs660895, an SNP recently identified as a risk factor for the autoimmune liver disease biliary cirrhosis.32 Analysis of SNP allele distributions in pathways further reinforces this observation. In multiple SNP analysis, MK0683 “antigen processing

and presentation” emerged as the pathway with the strongest association with HCC. Among the SNPs in this pathway, multiple variants at the HLA-DQB2 locus were observed to be associated with CNVs at the TCR loci. Analysis of copy number variation at TCR gene complexes supports the findings from the SNP analyses. Healthy individuals, on average, have lower copy number at the T-cell receptor loci TRA@ and TRG@ than do persons with HCC (Fig. 1). T-cell maturation involves TCR gene rearrangements that eliminate large portions of the T-cell receptor loci. Thus,

successful T-cell receptor rearrangements appear to occur less frequently in cancer patients. Because TCR CNV is absent in DNA LDK378 samples derived from liver tissue or immortalized B cells, the observed findings are attributable to somatic events occurring in T lymphocytes. CNV patterns at TRA@ suggest that rearrangement events generate functional alpha chain more frequently than delta chain. Low copy number segments observed in individual samples frequently encompass the TCR delta constant region, but rarely include the TCR alpha constant region (Fig. 2). Support for the idea that altered MCE公司 T-cell activation contributes directly to carcinogenesis in the liver, rather than simply being a systemic reaction to cancer, comes from the strong association we see between

CNV at the T-cell receptor loci and liver cirrhosis, a risk factor for and precursor to HCC (Table 2). Two of the three MHC class II locus SNPs whose genotypes correlate with HCC, rs9267673 and rs2647073, also exhibited strong association with LC (Table 3; Supporting Table S4). Although the role of the immune system in constitutional susceptibility to HCC is new, the involvement of the immune system in HCC carcinogenesis has been previously suggested in clinical studies and research involving model organisms. Increased activity of helper T cells, which promote inflammation, is associated with HCC.33 Conversely, activation and proliferation of cytotoxic T lymphocytes is suppressed in individuals with HCC.34, 35 Further, chronic inflammation has been implicated in the development of liver cancer in both animal models and in humans.

Further reinforcing the role of the immune system, individual SNP

Further reinforcing the role of the immune system, individual SNP analyses reveal that the MHC class II locus contains three variants (rs9267673, rs2647073, and rs3997872) strongly associated with HCC. MHC class II molecules present antigen to CD4+ (helper) T cells.31 The three SNPs may be associated with altered MHC class II proteins that result in an ineffective T-cell response. Interestingly, rs2647073 lies 3.4 kb from rs660895, an SNP recently identified as a risk factor for the autoimmune liver disease biliary cirrhosis.32 Analysis of SNP allele distributions in pathways further reinforces this observation. In multiple SNP analysis, Dabrafenib purchase “antigen processing

and presentation” emerged as the pathway with the strongest association with HCC. Among the SNPs in this pathway, multiple variants at the HLA-DQB2 locus were observed to be associated with CNVs at the TCR loci. Analysis of copy number variation at TCR gene complexes supports the findings from the SNP analyses. Healthy individuals, on average, have lower copy number at the T-cell receptor loci TRA@ and TRG@ than do persons with HCC (Fig. 1). T-cell maturation involves TCR gene rearrangements that eliminate large portions of the T-cell receptor loci. Thus,

successful T-cell receptor rearrangements appear to occur less frequently in cancer patients. Because TCR CNV is absent in DNA selleck compound samples derived from liver tissue or immortalized B cells, the observed findings are attributable to somatic events occurring in T lymphocytes. CNV patterns at TRA@ suggest that rearrangement events generate functional alpha chain more frequently than delta chain. Low copy number segments observed in individual samples frequently encompass the TCR delta constant region, but rarely include the TCR alpha constant region (Fig. 2). Support for the idea that altered MCE T-cell activation contributes directly to carcinogenesis in the liver, rather than simply being a systemic reaction to cancer, comes from the strong association we see between

CNV at the T-cell receptor loci and liver cirrhosis, a risk factor for and precursor to HCC (Table 2). Two of the three MHC class II locus SNPs whose genotypes correlate with HCC, rs9267673 and rs2647073, also exhibited strong association with LC (Table 3; Supporting Table S4). Although the role of the immune system in constitutional susceptibility to HCC is new, the involvement of the immune system in HCC carcinogenesis has been previously suggested in clinical studies and research involving model organisms. Increased activity of helper T cells, which promote inflammation, is associated with HCC.33 Conversely, activation and proliferation of cytotoxic T lymphocytes is suppressed in individuals with HCC.34, 35 Further, chronic inflammation has been implicated in the development of liver cancer in both animal models and in humans.