Correlation of Th17/Treg associated transcription factors with clinicopathological features of colorectal cancer and their prognostic significance.

Objective: To analyze the correlation of Th17/Treg associated transcription factors (TFs) with clinicopathological features of colorectal cancer (CRC) and their prognostic significance.

Methods: This research enrolled 56 CRC patients (experimental group, EG) and 50 healthy controls (control group, CG), who presented to Deqing People's Hospital between June 2017 and January 2019. The levels of Th17, Treg and their TFs [forkhead box protein P3 (Foxp3), retinoid acid receptor-related orphan receptor gamma t (RORγt)] and secreted inflammatory factors (IFs) [interleukin-17 (IL-17), interleukin-22 (IL-22)] were detected in the peripheral blood (PB) of both groups, and the TFs' phosphorylated protein expression was observed by Western blot. Further, the correlation of TFs with patients' pathological features was analyzed. Finally, a 3-year prognostic follow-up was performed on CRC patients. Receiver operating characteristic (ROC) determined the predictive value of Th17/Treg on the prognostic mortality of patients.

Results: Peripheral blood Th17 and Treg showed higher levels in the EG than in the CG, demonstrating excellent diagnostic effects on CRC (P<0.05). The EG also exhibited reduced Foxp3 and p-Foxp3 protein expression, and elevated RORγt and p-RORγt levels compared with the CG (all P<0.0001). In addition, the EG exhibited statistically higher IL-17 and IL-22 levels than the CG (all P<0.05). Further, the analysis of pathological features revealed close correlations of Th17/Treg, RORγt and Foxp3 with tumor size, TNM staging, degree of differentiation, and lymph node metastasis (LNM) of CRC patients (all P<0.001). Finally, the prognostic follow-up results identified that TNM staging, degree of differentiation, LNM, RORγt, Th17 and Treg were independent risk factors for prognostic mortality of CRC patients, while Foxp3 was an independent protective factor (all P<0.001).

Conclusion: Th17/Treg associated TFs are of great significance for the prognosis evaluation of CRC, the imbalance of which can cause aggravation of the inflammatory reaction and promote malignancy of CRC.