Evidence map›Paper›PMID 40547009›Full record

ArticleFrontiers in immunology2025

Lymphocyte exhaustion in hepatocellular carcinoma: a dynamic evolution across disease stages.

Carla Fuster-Anglada, Josep Corominas, Aida Marsal, Neus Llarch, Gemma Iserte, Marco Sanduzzi-Zamparelli, Alejandro Forner, Joana Ferrer-Fábrega, Victor Holguin, Albert Morales and 5 more

Erratum issuedAbstract read
In one paragraph

Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Carla Fuster-AngladaPathology Department, Centro de Diagnóstico Biomédico (CDB), Liver Oncology Unit, Hospital Clinic Barcelona, Barcelona, Spain.
Josep CorominasBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Aida MarsalBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Neus LlarchBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Gemma IserteBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Marco Sanduzzi-ZamparelliBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Alejandro FornerBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Joana Ferrer-FábregaBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Victor HolguinBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Albert MoralesBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Carolina SaavedraMedical Statistics Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic Barcelona, Barcelona, Spain.
Maria ReigBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Loreto BoixBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Montserrat MaríBarcelona Clinic Liver Cancer (BCLC) Group, Instituto De Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Alba DíazPathology Department, Centro de Diagnóstico Biomédico (CDB), Liver Oncology Unit, Hospital Clinic Barcelona, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Immune checkpoint inhibitors (ICIs) have transformed cancer therapy. However, their efficacy in hepatocellular carcinoma (HCC) is limited, highlighting the need to further explore immune microenvironments and novel biomarkers. This study examined lymphocyte populations and immune checkpoint dynamics in early, advanced, and post-progression HCC to better understand immune dynamics in HCC and to help identify predictive biomarkers and immune modulation strategies. Methods: Tumoral and non-tumoral liver tissues were analyzed from HCC patients across early (n=25), advanced (n=22), and advanced-beyond-progression (n=15) stages. Lymphocyte profiling was performed using immunohistochemistry and flow cytometry, focusing on NK cells, T cells, and immune exhaustion markers. An exploratory analysis of this profile and its association with disease progression and recurrence was conducted. Results: Early HCC exhibited higher liver-resident NK (lrNK) cell densities in non-tumor regions, which diminished with advanced stages. Increased CD56+ cell infiltration in the tumor core was associated with recurrence. Tumor region showed elevated PD-1, NKG2A, and CD39 expression in CD4+ and CD8+ T cells, indicating progressive immune exhaustion. Advanced HCC stages demonstrated altered NK cell phenotypes, with reduced cytotoxic activation (CD16) and increased residency markers (CXCR6/CD69) in tumor-isolated lymphocytes. Conclusions: Progressive immune exhaustion and dysregulation of lrNK and T cells in HCC reflect the evolution of the immune microenvironment originating in the tumor and leaking into the non-tumoral liver, progressively diminishing the cytotoxic capacity of NK and T cells. CD56+ cell density and immune checkpoint profiles are potential biomarkers for therapeutic response and disease monitoring, underscoring the need for personalized immunotherapy strategies.

Indexed as

Carcinoma, HepatocellularKiller Cells, NaturalLiver NeoplasmsLymphocytes, Tumor-InfiltratingAdultAgedDisease ProgressionFemaleHumansImmune System ExhaustionMaleMiddle AgedNeoplasm StagingTumor Microenvironmenthepatocellular carcinomaimmune exhaustionlymphocytesNK cellssorafenib

Identifiers

PMID40547009
PMCPMC12179174

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.