Study of Serum Soluble Programmed Death Ligand 1 as a Prognostic Factor in Hepatocellular Carcinoma in Egyptian Patients

Abstract

Background: The expression of programmed cell death ligands on tumor cells has a role in the suppression of antitumor immunity, resulting in tumor immune evasion. Objective: In this study, we evaluated the prognostic value of the soluble form of programmed death-ligand1 (sPD-L1) in Egyptian hepatocellular carcinoma (HCC) patients. Methods: This prospective cohort study was performed between November 2016 to November 2018 on 85 individuals (25 HCC patients, 25 HCC with vascular invasion and/or extrahepatic metastasis, 25 patients with liver cirrhosis, 10 healthy controls). The levels of sPD-L1 were determined in all subjects and compared in different groups and stages of cirrhosis and HCC. The association between sPD-L1 levels and overall survival (OS) was assessed. Results: Significant statistical difference in sPD-L1 was detected between different study groups. The cut-off value for normal sPD-L1 was defined by high sPD-L1 levels determined in a healthy control cohort. It was 2.522 ng/ml. In HCC patients, cut-off value was 7.42 ng/ml (sensitivity 88%, specificity 100%). In HCC with vascular invasion or metastasis, cut–off value was 9.62 ng/ml (sensitivity 88%, specificity 88%). Patients with high serum sPD-L1 or serum bilirubin concentrations had an increased risk of mortality. Conclusion: High sPD-L1 level could be a possible prognostic indicator for a poor outcome in liver cirrhosis and HCC patients. The predictive value of sPD-L1 levels for a successful anti- PD1/PD-L1 therapy should be investigated in the future.

Hepatocellular Carcinoma (HCC) in Egypt: A comprehensive overview

“…A recent systematic review identified 544 articles (16.2%) published in PubMed about HCC in Egypt [106]. In Egypt, some abnormalities in molecular pathways involved in HCC have been identified [107,108] but other abnormalities need to be identified on a large scale of HCC Egyptian patients using advanced technology. Identification of molecular characteristics of HCC Egyptian patients will pave the way for personalized therapy toward improvement of their overall survival [107].…”

Soluble Programmed Death Ligand-1 (sPD-L1): A Pool of Circulating Proteins Implicated in Health and Diseases

“…In most cases, the level of circulating sPD-L1 was found to be enhanced in the plasma of patients with the indicated pathology compared to healthy control (see Table 1 . For the oncology indications, the presence of sPD-L1 and its significance are discussed in the following studies: AEC [ 41 ]; BTC [ 42 , 43 ]; brain tumors [ 26 , 44 ]; CRCC [ 45 , 46 ]; CRC [ 47 ]; cutaneous melanoma [ 48 ]; DLBCL [ 49 , 50 ]; EOC [ 51 , 52 ]; ENKTL [ 53 , 54 ]; HNSCC [ 36 ]; HCC [ 55 , 56 , 57 ]; HL [ 54 , 58 ]; mesothelioma [ 59 , 60 ]; NC [ 61 , 62 ]; PGC [ 63 , 64 , 65 ]; NSCLC [ 66 , 67 ]; PC [ 68 ]; PCNSL [ 50 ]; STS [ 69 , 70 ]; TC [ 71 ]; TNBC [ 72 ]; WM [ 73 ].…”

A nomogram for prediction of early allograft dysfunction in living donor liver transplantation

“…[ 27 ] Other prognostic factor, the soluble form of programmed death ligand 1 (sPD-L1) on tumor cells, when elevated, has also been found to be prognostic indicator for poor outcome. [ 28 ] Huge HCC, defined as a tumor diameter greater or equal to 10 cm, complete resection was believed to be potentially curative; however, the approach and extent of resection remain unclear. HCC with diaphragmatic invasion often requires tumor en bloc with part of the diaphragm is often resected and anterior approach is recommended in minimizing intraoperative bleeding.…”