Title : Study on the expression and relationship of CD24, CD47, and PD-L1 in HBV-associated hepatocellular carcinoma
Abstract:
Background and purpose:
Hepatocellular carcinoma (HCC) is one of the most common and invasive malignancies, and hepatitis B virus (HBV) infection is the leading risk factor of HCC worldwide. Currently, immune checkpoint inhibitor (ICI) therapy is the new standard treatment for advanced or metastatic HCC, yet many patients still fail to respond. The purpose of this study was to explore the expression and prognosis of CD24, CD47 and PD-L1 in patients with HBV-associated HCC.
Materials and methods:
The postoperative specimens and clinical data of patients with HBV-associated HCC who underwent radical surgery in Fujian Provincial Hospital between January 2014 and January 2018, September 2022 and October 2022 were collected in this study, and the end events were defined as death when reaching the follow-up time. Immuohistochemical staining was used to detect the expression of CD24, CD47 and PD-L1 in paraffin-embedded specimens. Real-time qPCR was used to detect the expression of CD24, CD47 and PD-L1 in nine pairs of fresh cancerous tissues and pericarcinomatous tissues. And the relationship between CD24, CD47, PD-L1 and the prognosis and clinicopathological factors of HBV-associated HCC was analyzed.
Result:
A total of 67 patients with HBV-associated HCC were included, including 55 males (82.09%) and 12 females (17.91%); the age range was 23 to 74 years. The median OS of the patients was 44 months (95% CI:38.69-49.31months) , and the median PFS of the patients was 32 months (95% CI:26.19-37.81months). The cumulative 1-year survival rate was 86.57%, the cumulative 2-year survival rate was 80.60%, and the cumulative 5-year survival rate was 29.85%. The rate of 1-year PFS after operation was 71.64%, the rate of 2-years PFS was 61.94%, and the rate of 5-years PFS was 16.42%. Univariate survival analysis showed that high expression of PD-L1 and CD24 was related to poorer OS and PFS in patients with HBV-associated HCC, but there was no significant difference in OS and PFS between low and high CD47 expression. The correlation analysis showed that the expression of PD-L1 was significantly correlated with the neoplasm staging and differentiation of HBV-associated HCC, and the expression of CD24 was significantly correlated with the expression of Hepar-1 and tumor staging. The results of correlation analysis also showed that PD-L1 was significantly positively correlated to CD24 and CD47, respectively. Whereas there was no significant correlation between CD24 and CD47. Real-time qPCR results showed the expression of CD24 was significantly higher in cancerous tissues than pericarcinomatous tissues in five patients, the expression of CD47 was significantly higher in cancerous tissues than pericarcinomatous tissues in four patients and the expression of PDL1 was significantly higher in cancerous tissues than pericarcinomatous tissues in three patients.
Conclusion
This study demonstrated that high PD-L1 and CD24 expression can be used as risk factors for poor prognosis in patients with HBV-associated HCC. Additionally, we found that PD-L1 was significantly positively correlated to CD24 and CD47, which provided a basis for clinical double-targeted immunotherapy for HBV-associated HCC.
Audience Take Away:
- This study demonstrated that high PD-L1 and CD24 expression can be used as risk factors for poor prognosis in patients with HBV-associated hepatocellular carcinoma. Additionally, we found that PD-L1 was significantly positively correlated to CD24 and CD47
- Our research provided evidence for combined Immunotherapy for HBV-associated hepatocellular carcinoma
- This research that other faculty could use to expand their research or teaching in hepatocellular carcinoma
- This research will provide a practical solution to the problem that patients with hepatocellular carcinoma have poor prognosis
