ArticleWorld journal of clinical oncology2026
T cell exhaustion markers in hepatitis C virus-related hepatocellular carcinoma: Expression patterns and prognostic significance in an Egyptian cohort.
Article in World journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, particularly in Egypt, where hepatitis C virus (HCV) prevalence is high. T cell exhaustion markers such as programmed death 1 (PD-1), T cell immunoglobulin and ITIM domain, and T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3) play a crucial role in HCC immune evasion; however, their expression patterns in Egyptian patients remain underexplored.
aimTo characterize the expression of PD-1, T cell immunoglobulin and ITIM domain, and TIM-3 on CD4+ and CD8+ T cells across HCV-related liver disease stages and to determine their association with disease severity and survival in an Egyptian cohort.
methodsThis prospective case-control study included 200 Egyptian participants: 50 with HCV-related HCC, 50 with HCV-related cirrhosis, 50 with chronic HCV infection, and 50 healthy controls (HCV-negative by polymerase chain reaction). Flow cytometry quantified immune exhaustion markers, and clinical data were analyzed using multivariate and survival modeling frameworks, adjusting for key confounders.
resultsHCC patients showed significantly higher expression of all T-cell exhaustion markers than other groups (
conclusionElevated T cell exhaustion markers were linked to advanced disease and poor survival in Egyptian patients with HCV-related HCC. Machine learning and mediation analyses identified CD4/PD-1 and CD8/TIM-3 as independent prognostic biomarkers, reinforcing their potential as therapeutic targets. These findings provide novel insights from a high-HCV-prevalence setting, supporting the integration of immune exhaustion profiling into risk stratification for HCC.
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