The effects of immune checkpoint modulators on the clinical course of patients with resectable hepatocellular carcinomaopen accessThe effects of immune checkpoint modulators on the clinical course of patients with resectable hepatocellular carcinoma
- Other Titles
- The effects of immune checkpoint modulators on the clinical course of patients with resectable hepatocellular carcinoma
- Authors
- 안지현; 강효정; 유은실; 이한주; 심주현
- Issue Date
- Mar-2022
- Publisher
- 대한간암학회
- Keywords
- Liver neoplasms; Prognosis; CTLA-4; PD-L1; PD-1
- Citation
- Journal of Liver Cancer, v.22, no.1, pp.40 - 50
- Indexed
- KCI
- Journal Title
- Journal of Liver Cancer
- Volume
- 22
- Number
- 1
- Start Page
- 40
- End Page
- 50
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/139223
- DOI
- 10.17998/jlc.2022.03.06
- ISSN
- 2288-8128
- Abstract
- Background/Aim: Immune checkpoint proteins regulating T-cell mediated anti-tumor immunity have been reported to affect clinical outcomes in multiple malignancies. This study aimed to investigate the prognostic effect of histological expression of immune checkpoint proteins in patients with resected hepatocellular carcinoma (HCC).
Methods: A total of 221 patients with HCC who underwent curative resection were included. Expression of programmed-cell death ligand-1 (PD-L1) in tumor cells (tPD-L1) and tumor infiltrating mononuclear cells (TIMCs) (iPD-L1), programmed-cell death-1 in TIMCs (iPD-1), and cytotoxic T lymphocyte antigen-4 in TIMCs (iCTLA-4) were measured immunohistochemically.
Results: Histo-positivity for iCTLA-4, iPD-1, iPD-L1, and tPD-L1 was 32.1%, 42.5%, 35.3%, and 14.9%, respectively. Multivariate logistic analyses revealed that male sex and tumor >5 cm were variables related to iCTLA-4 positivity (odds ratio [OR], 0.46 and 1.94, respectively; P<0.05). Poor differentiation was related to PD-L1 expression in both tumor cells and TIMCs (OR, 2.88 and 3.46, respectively; P<0.05). Microvascular invasion was significantly associated only with iPD-L1 (OR, 2.24; P<0.05). In time-dependent outcome analyses, expression of immune checkpoint proteins in TIMCs (i.e., iCTLA-4, iPD-1, and iPD-L1) was significantly related to longer overall survival and non-cancer-related survival (all P<0.05), but not to time-to-recurrence or cancer-specific deaths. Concurrent activation of the PD-1:PD-L1 and CTLA-4 pathways predicted improved outcomes in terms of overall survival and non-cancer related survival (P=0.06 and P=0.03, respectively).
Conclusions: Immune checkpoint proteins upregulated in TIMCs in HCC tissues have individual and additive effects in prolonging the survival of patients, specifically in terms of survival not related to cancer recurrence.
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