Serum T Cell Immunoglobulin Mucin 3 Predicts Worse Prognosis in Hepatocellular Carcinoma Patients Undergoing Transcatheter Arterial Chemoembolization.

BACKGROUND Hepatocellular carcinoma (HCC) is currently a leading cause of cancer-related death, and its prognostic evaluation remains a challenge. We aimed to explore the predictive value of T cell immunoglobulin and mucin 3 (Tim-3) in HCC patients undergoing transcatheter arterial chemoembolization (TACE). MATERIAL AND METHODS For the present study, 167 HCC patients who had undergone TACE were retrospectively recruited and randomly stratified into 2 subgroups at a ratio of about 2: 1 (training: 109; validation: 58) using EXCEL software. Pre-TACE serum was collected from all of these patients, and in a second visit a month after the initial treatment, an additional serum sample was collected from 45 patients in the training set. Tim-3 concentrations were determined by enzyme-linked immunosorbent assay. Kaplan-Meier survival curves analysis, log-rank tests, and Cox proportional hazard regression model were applied to evaluate prognostic significance. RESULTS Patients whose cancer progressed after TACE had significantly higher serum Tim-3 in both the training and validation sets (both P<0.05). Kaplan-Meier analysis revealed that patients with elevated serum Tim-3 had significantly shorter time-to-progression and overall survival in both the training and validation sets (both P<0.05). Multivariate Cox regression analysis confirmed that elevated pre-TACE Tim-3 served as a novel, independent indicator for predicting poor prognosis in HCC [progression, hazard ratio (HR) 2.197; 95% confidential interval (CI) 1.408-3.373; P<0.001; death, HR 2.570; 95% CI 1.508-4.378; P=0.001], which was further verified in the validation set (progression P=0.005; death P=0.043). Interestingly, serum Tim-3 retained its prognostic significance in the a-fetoprotein-negative subgroup. Notably, patients with high Tim-3 levels after TACE encountered dismal outcomes. CONCLUSIONS Serum Tim-3 might be a satisfactory prognostic indicator for HCC patients undergoing TACE.