Measurement invariance of the strength of motivation for medical school: a multi-group confirmatory factor analysis

BACKGROUND

The Strength of Motivation for Medical School-Revised (SMMS-R) questionnaire measures students' motivation for studying medicine. It includes three subscales: 'willingness to sacrifice', 'readiness to start', and 'persistence'. Measurement invariance is a prerequisite for group comparisons. The objectives of this study were to verify the factorial structure of the SMMS-R questionnaire and to investigate it's measurement invariance.

METHODS

A total of 989 medical students were approached, 930 cases were kept for data analysis. Factorial structure of and measurement invariance of the SMMS-R were tested using single and multiple group confirmatory factor analyses with Mplus. Trational Cronbach's α along with McDonald's ω and glb were used to measure internal consistency for each subscale.

RESULTS

Internal consistency for subscales and the full instrument were within the acceptable range. A 3-factor structure of the Chinese version of the SMMS-R was supported. Full configural, metric and partial scalar invariance were obtained.

CONCLUSIONS

The SMMS-R showed measurement invariance across gender and two independent samples. So it can be used for group and cross-cultural comparisons.

Opioid Analgesic Prescribing Practices of Dental Professionals in the United States

The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19-1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17-1.41), 0.57 (95% CI, 0.47-0.70), and 0.84 (95% CI, 0.75-0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

Therapeutic effects of CSF1R-blocking antibodies in multiple myeloma

Our previous studies showed that macrophages (MФs), especially myeloma-associated MФs (MAMs), induce chemoresistance in human myeloma. Here we explored the potential of targeting MФs, by using colony-stimulating factor 1 receptor (CSF1R)-blocking mAbs, to treat myeloma. Our results showed that CSF1R blockade specifically inhibited the differentiation, proliferation and survival of murine M2 MФs and MAMs, and repolarized MAMs towards M1-like MФs in vitro. CSF1R blockade alone inhibited myeloma growth in vivo, by partially depleting MAMs, polarizing MAMs to the M1 phenotype, and inducing a tumor-specific cytotoxic CD4⁺ T-cell response. Similarly, genetically depleting MФs in myeloma-bearing MM^DTR mice retarded myeloma growth in vivo. Furthermore, the combination of CSF1R blockade and chemotherapy such as bortezomib or melphalan displayed an additive therapeutic efficacy against established myeloma. Finally, a fully human CSF1R blocking mAb, similar to its murine counterpart, was able to inhibit the differentiation, proliferation and survival of human MФs. Thus, this study provides the first direct in vivo evidence that MΦs and MAMs are indeed important for myeloma development and progression. Our results also suggest that targeting MAMs by CSF1R blocking mAbs may be promising methods to (re)sensitize myeloma cells to chemotherapy and promote anti-myeloma immune responses in patients.

[Effects of trabecular metal augments for the reconstruction of Paprosky type Ⅲ acetabulum bone defects]

Objective: To investigate the methods and short-time clinical results of reconstruction of Paprosky type Ⅲ acetabulum bone defects by using tantalum augments. Methods: A total of 17 patients (17 hips) with Paprosky type Ⅲ acetabulum bone defects, treated with tantalum augments in revision of total hip arthroplasty at Department of Orthopedics Surgery in General Hospital of Chinese People's Liberation Army were retrospectively analyzed from March 2014 to May 2016.There were 6 males and 11 females aged from 23 to 74 years with an average of (50.2±16.3) years. Tantalum augments or TM-Cup augment (the cup-on-cup technique) were used to reconstruct the defects.The TM-Cup augment was the tantalum revision cup which was removed titanium ring. The cup-on-cup technique combined TM-Cup augment and biological acetabulum cup. Augments were served as the nonresorptive structural allograft in revision of total hip arthroplasty. Harris hip score was used to evaluate clinical effects. The vertical position of the rotation center was measured and analyzed. Radiographic assessments of the acetabular components were performed by DeLee-Charnley and the Anderson criteria and recorded postoperative complications. Results: All the patients were followed up from 3 to 29 months with an average of (16.2±5.4) months, tantalum augments and biological acetabulum cup were used in 13 patients, the TM-Cup augment and biological acetabulum cup were used in 4 patients. At the time of the latest follow-up, the mean Harris hip score increased compared to preoperatively (86.8±8.3 vs. 30.0±12.0) (t=12.78, P<0.01), the average vertical location of the center of rotation was decreased ((25.3±9.8) mm vs.(47.6±10.5)) mm (t=4.95, P<0.01). All the tantalum augments and biological acetabulum cups were stable, there were no infection, dislocation and other complications. Conclusions: The use of tantalum augments could be considered as an effective management of Paprosky type Ⅲ defects providing good clinical and radiographic outcomes in the short term.The cup-on-cup technique which was used in reconstruction of severe superior-invagination acetabular bone defects and restoration relatively normal center of rotation had special application value.

Cancer-FOXP3 directly activated CCL5 to recruit FOXP3+Treg cells in pancreatic ductal adenocarcinoma

Forkheadbox protein 3 (FOXP3), initially identified as a key transcription factor for regulatory T cells (Treg cells), was also expressed in many tumors including pancreatic ductal adenocarcinoma (PDAC). However, its role in PDAC progression remains elusive. In this study, we utilized 120 PDAC tissues after radical resection to detect cancer-FOXP3 and Treg cells by immunohistochemistry and evaluated clinical and pathological features of these patients. Cancer-FOXP3 was positively correlated with Treg cells accumulation in tumor tissues derived from PDAC patients. In addition, high cancer-FOXP3 expression was associated with increased tumor volumes and poor prognosis in PDAC especially combined with high levels of Treg cells. Overexpression of cancer-FOXP3 promoted the tumor growth in immunocompetent syngeneic mice but not in immunocompromised or Treg cell-depleted mice. Furthermore, CCL5 was directly trans-activated by cancer-FOXP3 and promoted the recruitment of Treg cells from peripheral blood to the tumor site in vitro and in vivo. This finding has been further reinforced by the evidence that Treg cells recruitment by cancer-FOXP3 was impaired by neutralization of CCL5, thereby inhibiting the growth of PDAC. In conclusion, cancer-FOXP3 serves as a prognostic biomarker and a crucial determinant of immunosuppressive microenvironment via recruiting Treg cells by directly trans-activating CCL5. Therefore, cancer-FOXP3 could be used to select patients with better response to CCL5/CCR5 blockade immunotherapy.

Effect of Tempol on the prevention of irradiation-induced mucositis in miniature pigs

OBJECTIVE

The goals of this study were to (i) establish a useful miniature pig (minipig) model for irradiation-induced oral mucositis and (ii) evaluate the effect of Tempol to prevent its development.

METHODS AND MATERIALS

Minipigs were irradiated with 6 Gy for five consecutive days targeting the entire oral cavity. To prevent radiation damage, minipigs were treated with 30 mg kg^-1 Tempol 10 min before irradiation (n = 4), while the radiation-alone group was similarly injected with saline (n = 4). Lesions were graded using an oral mucositis score and visual inspection every 3 days, and biopsy of multiple sites was performed at day 18. Weight and chest and abdominal circumferences were measured every 3 days.

RESULTS

Lesions began about 12 days after the first irradiation fraction and healed about 30 days after irradiation. Epithelial thickness was calculated on the lingual and buccal mucosa on the 18th day after the first irradiation fraction. Tempol provided modest protection from ulceration after irradiation using this treatment strategy.

CONCLUSIONS

This study established a useful large animal model for irradiation-induced oral mucositis and showed modest beneficial effects of Tempol in limiting tissue damage. The latter finding may be potentially valuable in preventing oral mucositis in patients receiving irradiation for head and neck cancers.

Abstract P6-01-19: Decoding the genetic basis of mammary mineralization and their putative role in promotion of distant metastases

Background: Breast microcalcifications are the sole early stage diagnostic markers of breast cancer. The association of mineralization (especially type II microcalcifications) with both benign and malignant lesions often leads to unnecessary biopsies. The processes by which these ectopic microcalcifications form are unknown. In the current work, we attempted to explore the possibility of obtaining genes responsible for the formation of microcalcifications in breast cancer cell lines at cellular level and understand their potential involvement in disease progression and distant metastases.

Methods:The GEO dataset GSE16795 used in this study contains gene expression profiles of 28 human breast cancer cell lines that were divided into two groups - metastatic and non-metastatic. Gene expression levels of OPN were found to be significantly (p=0.0002) elevated for the metastatic group compared to the non-metastatic group. Hence, the human breast cancer cell lines - metastatic (MDA-MB-231 and SUM 149) and non-metastatic (BT-474 and T47D) from the American Type Culture Collection were cultured and their OPN expression at mRNA and protein levels determined by qRT-PCR and Western blotting were compared. Additionally the same cell lines were cultured in media enriched with an osteogenic cocktail containing 10mM β-glycerophosphate (Sigma, USA) and 50 mg/ml-1 ascorbic acid (Sigma, USA) for induction of microcalcifications.Next, several clones were generated using shRNA knockdown of OPN gene in MDA-MB-231 cells for further study. In vitro studies were conducted to assess the effects of OPN knockdown on the migration and invasion potential of MDA-MB-231 cells using transwell migration assays.

Results: The expression of OPN at both mRNA and protein levels are significantly higher for the metastatic cell lines when compared to non-metastatic cell lines. It can also be observed that OPN expression in the cells increases substantially with addition of exogenous phosphates in the form of osteogenic cocktail and thereby indicating that OPN possibly plays a crucial role in mediating formation of microcalcifications in these cells(P&lt;0.001). Metastatic cell line MDA-MB-231 was employed as a model system for further investigation in this study. There is a consistent inhibition of formation of cellular microcalcifications due to the knockdown of gene responsible for OPN, suggesting that OPN gene is directly associated with the formation and regulation of hydroxyapatite formation in MDA-MB-231 breast cancer. Further, the above observation is strengthened by the similarity of the trend of variation in level of mRNA expression of OPN and cellular calcification content across the knockdown clones. OPN knockdown cell lines show reduced cell migration and invasion in the assays compared to the control MDA-MB-231 cells.

Conclusion: The knockdown of OPN gene not only reduced the formation of microcalcifications in the cells in response to osteogenic cocktail but also affected their migration and invasion characteristics. The observed dual roles of the OPN gene encourage us to probe further into the possible existence of a direct relationship between microcalcifications and ability to metastasize to distant organs mediated by common genetic factors in the future.

Citation Format: Zheng C, Rizwan A, Paidi SK, Yu Z, Barman I, Glunde K. Decoding the genetic basis of mammary mineralization and their putative role in promotion of distant metastases [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-01-19.

Abstract P6-01-18: Early detection of development of a pre-metastatic niche in lungs in response to primary breast tumor using Raman spectroscopy

Background: An alarmingly large proportion of cancer-related deaths result from metastatic cancers. Development of quick, reliable and non-invasive or minimally invasive approaches to objectively assess the secondary tissues (potentially in vivo) will be instrumental in substantially reducing the cancer burden due to metastasis, which accounts for majority of cancer related mortality. In our study we report the utilization of Raman spectroscopy and chemometric techniques in identifying formation of pre-metastatic niche in lungs prior to observing morphological changes.

Methods: Six-week-old female athymic nu/nu mice (NCI, MD) were implanted with 2x106 cells of human breast cancer cell lines - MDA-MB-231 (n=3), and MCF-7 (n=3) in their fourth right mammary fat pad orthotopically. And control mice (n=3) without tumor cell implantation were also employed. The primary tumor size was monitored and the mice were sacrificed within 8-12 weeks of cell implantation when the primary tumors volume grew to 500-600 mm3. Control mice were also sacrificed in this timeframe. The freshly excised lungs of the mice were cleaned in PBS and utilized for obtaining Raman spectra (830 nm, thermoelectrically cooled CCD). Each tissue was collected from multiple points. Principal component analysis (PCA) and Partial least squares discriminant analysis (PLS-DA) were employed as discriminating algorithm. Following spectral acquisition, the tissues were fixed in 10% formalin, embedded in paraffin, and then HE staining, and Masson's trichrome staining for collagen. Collagen quantification of Masson's trichrome stained slides was achieved using MATLAB (Mathworks, MA). The Institutional Animal Care and Use Committee at Johns Hopkins University School of Medicine approved the protocol of the study.

Results: 900 Raman spectra each acquired from the lungs of the control mice and mice bearing MCF-7 and MDA-MB-231 tumor xenografts were assigned class labels - 'Control', 'MCL' and 'MDL' respectively for further analysis. Select principal components from those obtained by subjecting all the chosen 900 spectra to PCA clearly evident that the differences in the Raman spectra belonging to tissues being primed by derivatives of different primary cells are quite pronounced. The average correct rates of PLS-DA prediction of 90.1%, 97.7% and 78.4% were obtained for the spectra belonging to the classes - Control, MCL and MDL respectively. The HE images are negative for any signs of cancerous lesions. Masson's trichrome staining results show that the metastatic potential of the cell lines responsible for the primary tumor is positively correlated with the collagen density in the pre-metastatic niche, the MDL shows the highest collagen density (P&lt;0.001). These differences clearly indicate the remodeling of extracellular matrix anticipating incoming tumor cells in response to primary tumor derived factors occurs very early in the metastatic cascade.

Conclusion: The current study introduces Raman spectroscopy in conjunction with chemometric techniques as are liable and minimally invasive tool for diagnosis of metastatic cancers significantly early in the metastatic cascade, and also opens a new route for early targeting of cancer metastasis and its associated burden.

Citation Format: Zheng C, Rizwan A, Paidi SK, Yu Z, Barman I, Glunde K. Early detection of development of a pre-metastatic niche in lungs in response to primary breast tumor using Raman spectroscopy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-01-18.

Long noncoding RNAs as novel serum biomarkers for the diagnosis of hepatocellular carcinoma: a systematic review and meta-analysis

PURPOSE

Long noncoding RNAs (lncRNAs) are outstanding as novel cancer biomarkers with great prospects. Herein, we focused on summarizing the overall diagnostic evaluation of lncRNAs for hepatocellular carcinoma (HCC).

METHODS

Relevant literature was collected from the online databases. The Quality Assessment for Studies of Diagnostic Accuracy checklist was used to assess the quality of included studies. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were plotted using random-effects models. Summary receiver operating characteristic curve and the area under the curve (AUC) were used to estimate the overall test performance. Statistical analysis was performed by STATA 14.0 and Meta-DiSc 1.4 software.

RESULTS

Ten studies with a total of 820 HCC patients and 785 healthy controls were included. For overall lncRNAs, the pooled sensitivity, specificity, and DOR to predict HCC patients were 80% [95% confidence interval (CI) 77-82%], 79% (95% CI 76-81%), and 27.66 (95% CI 14.26-53.63), respectively, corresponding to an AUC of 0.91.

CONCLUSIONS

LncRNAs were a high diagnostic value for HCC and its expression could potentially be used as auxiliary biomarker in confirming HCC.

Immune reactivity after adenoviral-mediated aquaporin-1 cDNA transfer to human parotid glands

OBJECTIVES

The purpose of this study was to examine the humoral and cellular immune reactivity to adenoviral vector (AdhAQP1) administration in the human parotid gland over the first 42 days of a clinical gene therapy trial.

METHODS

Of eleven treated subjects, five were considered as positive responders (Baum et al, 2012). Herein, we measured serum neutralizing antibody titers, circulating cytotoxic lymphocytes, and lymphocyte proliferation in peripheral blood mononuclear cells. Additionally, after adenoviral vector stimulation of lymphocyte proliferation, we quantified secreted cytokine levels.

RESULTS

Responders showed little to modest immune reactivity during the first 42 days following gene transfer. Additionally, baseline serum neutralizing antibody titers to serotype 5-adenovirus generally were not predictive of a subject's response to parotid gland administration of AdhAQP1. Cytokine profiling from activated peripheral blood mononuclear cells could not distinguish responders and non-responders.

CONCLUSIONS

The data are the first to describe immune responses after adenoviral vector administration in a human parotid gland. Importantly, we found that modest (2-3 fold) changes in systemic cell-mediated immune reactivity did not preclude positive subject responses to gene transfer. However, changes beyond that level likely impeded the efficacy of gene transfer.

Thermodynamic origin of instability in hybrid halide perovskites

Degradation of hybrid halide perovskites under the influence of environmental factors impairs future prospects of using these materials as absorbers in solar cells. First principle calculations can be used as a guideline in search of new materials, provided we can rely on their predictive capabilities. We show that the instability of perovskites can be captured using ab initio total energy calculations for reactants and products augmented with additional thermodynamic data to account for finite temperature effects. Calculations suggest that the instability of CH₃NH₃PbI₃ in moist environment is linked to the aqueous solubility of the CH₃NH₃I salt, thus making other perovskite materials with soluble decomposition products prone to degradation. Properties of NH₃OHPbI₃, NH₃NH₂PbI₃, PH₄PbI₃, SbH₄PbI₃, CsPbBr₃, and a new hypothetical SF₃PbI₃ perovskite are studied in the search for alternative solar cell absorber materials with enhanced chemical stability.

Platelet aggregation promoted by biofilms of oral bacteria and the effect of mouth rinses in vitro

INTRODUCTION

The purpose of this study was to observe platelet aggregation promoted by biofilms of Streptococcus sanguinis and Porphyromonas gingivalis and to evaluate the effect of two different mouth rinses on this process.

METHODOLOGY

In the first experiment, the same amount of S. sanguinis, P. gingivalis, and the S. sanguinis + P. gingivalis mixed solution was added to an equivalent amount of platelet-rich plasma (PRP). Aggregation was measured using a recording platelet aggregometer. In the second experiment, S. sanguinis, P. gingivalis, S sanguinis + P. gingivalis mixed solutions were pretreated with either Listerine antiseptic mouth rinse or Xipayi mouth rinse for 3 minutes, 6 minutes, and 10 minutes, respectively. The same amount of solution was added to the PRP, and the inhibition of aggregation was measured.

RESULTS

In the first experiment, S. sanguinis and P. gingivalis were able to induce platelet aggregation. The aggregation rate of S. sanguinis + P. gingivalis was significantly lower than that of either S. sanguinis or P. gingivalis. In the second experiment, when S. sanguinis, P. gingivalis, and the S. sanguinis + P. gingivalis mixed solutions were pretreated with Listerine antiseptic mouth rinse for 3 minutes and Xipayi mouth rinse for 10 minutes, there was no significant platelet aggregation.

CONCLUSIONS

Platelets could adhere to S. sanguinis or P. gingivalis, but when S. sanguinis was mixed with P. gingivalis, the aggregation rate was reduced significantly. Treatment with Listerine antiseptic mouth rinse or Xipayi mouth rinse inhibited the ability of the bacteria to induce platelet aggregation.

[Effect of standardized treatment on reactivity of toe microcirculation in patients with type 2 diabetes mellitus]

OBJECTIVE

To evaluate the effect of standardized treatment on reactivity of the lower limb terminal microcirculation in patients with type 2 diabetes mellitus (T2DM) by high frequency ultrasound combined with warm bath.

METHODS

A total of 66 patients with T2DM were collected from June 2014 to May 2015 in the Second Affiliated Hospital of Wenzhou Medical University.According to the vascular complications , the patients were divided into group A without complications (36 cases)and group B with complications (30 cases). Hemodynamic parameters such as peak systolic velocity(PSV), end-diastolic velocity(EDV) and resistance index(RI) of the right plantar digital artery on fibular side of the 1st toe were acquired through Doppler in all subjects.Then the above operation were performed repetitively on all subjects after the right foot was immersed in 40 ℃ warm water for 5 minutes.The change rates of PSV, EDV and RI were calculated after warm bath.All subjects were examined again after three months treatment .The growth rates of the change rate of PSV, EDV and RI were calculated after treatment.All parameters were analyzed.

RESULTS

The change rates of the parameters in group B before and after treatment were lower than those of group A, before treatment (0.108±0.077 vs 0.184±0.091, P=0.037, 0.184±0.101 vs 0.380±0.167, P=0.002, 0.007±0.004 vs 0.015±0.008, P=0.028 7), after treatment (0.155±0.111 vs 0.421±0.138, 0.287±0.108 vs 0.794±0.286, 0.012±0.008 vs 0.039±0.014, P=0.000); the post treatment growth rates of the change rates of the parameters in group B were all less than those of group A (0.414±0.303 vs 2.192±2.673, P=0.048, 0.660±0.406 vs 1.422±1.075, P=0.042, 0.633±0.830 vs 2.191±2.269, P=0.048). The change rates of the parameters in two groups after treatment were higher than those before treatment (all P<0.05).

CONCLUSION

Warm bath test can be used to detect change degree of hemodynamic parameters in patients with T2DM so as to evaluate reactivity of blood microcirculation, which has a certain clinical application value in treatment.

Local proliferation initiates macrophage accumulation in adipose tissue during obesity

Obesity-associated chronic inflammation is characterized by an accumulation of adipose tissue macrophages (ATMs). It is generally believed that those macrophages are derived from peripheral blood monocytes. However, recent studies suggest that local proliferation of macrophages is responsible for ATM accumulation. In the present study, we revealed that both migration and proliferation contribute to ATM accumulation during obesity development. We show that there is a significant increase in ATMs at the early stage of obesity, which is largely due to an enhanced in situ macrophage proliferation. This result was obtained by employing fat-shielded irradiation and bone marrow reconstitution. Additionally, the production of CCL2, a pivotal chemoattractant of monocytes, was not found to be increased at this stage, corroborating with a critical role of proliferation. Nonetheless, as obesity proceeds, the role of monocyte migration into adipose tissue becomes more significant and those new immigrants further proliferate locally. These proliferating ATMs mainly reside in crown-like structures formed by macrophages surrounding dead adipocytes. We further showed that IL-4/STAT6 is a driving force for ATM proliferation. Therefore, we demonstrated that local proliferation of resident macrophages contributes to ATM accumulation during obesity development and has a key role in obesity-associated inflammation.

Relationship between HLA-DP gene polymorphisms and the risk of hepatocellular carcinoma: a meta-analysis

The association between the HLA-DP single nucleotide polymorphisms (SNPs) rs3077 and rs9277535 and hepatocellular carcinoma (HCC) has been reported, but results have been inconclusive and controversial. Therefore, to investigate the relationship between these HLA-DP SNPs and HCC susceptibility, a meta-analysis of studies published before January 2014 was carried out using the PubMed and Google Scholar databases. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated for HLA-DP alleles, and for co-dominant, dominant, and recessive genotype models of each SNP, based on fixed- or random-effects models. A total of nine studies from six published articles were included. The association study between rs3077 and HCC susceptibility was performed in four independent comparisons that contained 1871 cases with hepatitis B virus (HBV)-related HCC and 3207 carriers with persistent HBV. Association between rs9277535 and HCC susceptibility was examined in five separate comparisons that contained 2017 cases and 3930 carriers. Our analysis indicated a significant association of rs3077 and rs9277535 with HCC susceptibility, suggesting that rs3077 might act beneficially against HCC susceptibility (A vs G: OR = 0.884, 95%CI = 0.803-0.973, P = 0.012; GA vs GG: OR = 0.842, 95%CI = 0.733-0.967, P = 0.015; AA+GA vs GG: OR = 0.848, 95%CI = 0.744-0.968, P = 0.014), and that rs9277535 might promote HCC susceptibility (AA vs GA: OR = 1.202, 95%CI = 1.011-1.428, P = 0.037). This study suggested that HLA-DP rs3077 and rs9277535 polymorphisms are associated with HCC susceptibility in the Asian population.