Published online Aug 18, 2015. doi: 10.4254/wjh.v7.i17.2080
Peer-review started: April 1, 2015
First decision: April 23, 2015
Revised: May 28, 2015
Accepted: July 18, 2015
Article in press: July 22, 2015
Published online: August 18, 2015
Hepatocellular carcinoma (HCC) is primarily a malignancy of the liver, advancing from a damaged, cirrhotic liver to HCC. Globally, HCC is the sixth most prevalent cancer and the third-most prevalent reason for neoplastic disease-related deaths. A diverse array of infiltrating immunocytes regulates the development and progression of HCC, as is the case in many other cancers. An understanding of the various immune components during HCC becomes necessary so that novel therapeutic strategies can be designed to combat the disease. A dysregulated immune system (including changes in the number and/or function of immune cells, cytokine levels, and the expression of inhibitory receptors or their ligands) plays a key role in the development of HCC. Alterations in either the innate or adaptive arm of the immune system and cross-talk between them make the immune system tolerant to tumors, leading to disease progression. In this review, we have discussed the status and roles of various immune effector cells (e.g., dendritic cells, natural killer cells, macrophages, and T cells), their cytokine profile, and the chemokine-receptor axis in promoting or impeding HCC.
Core tip: Hepatocellular carcinoma (HCC) is a heterogeneous disease caused by multiple factors, and has its immunopathogenesis complicated by the paradoxical role of various immune cells. This review provides a comprehensive insight into the immunological mechanisms that control hepatocarcinogenesis. A better and fuller understanding of the precise function of each cellular subset may open new avenues for the treatment of HCC.