Copyright
©The Author(s) 2024.
World J Gastrointest Oncol. Jul 15, 2024; 16(7): 3256-3269
Published online Jul 15, 2024. doi: 10.4251/wjgo.v16.i7.3256
Published online Jul 15, 2024. doi: 10.4251/wjgo.v16.i7.3256
Table 1 Baseline patient data
Variables | T + A (n = 58) | T + L (n = 42) | T + S (n = 64) | T + D (n = 49) | P value |
Age (≥ 55/< 55) | 33/25 | 33/9 | 36/28 | 30/19 | 0.092 |
Sex (female/male) | 10/48 | 6/36 | 7/57 | 8/41 | 0.768 |
Etiology | 0.075 | ||||
Hepatitis B virus | 54 | 40 | 60 | 47 | |
Hepatitis C virus | 0 | 0 | 0 | 0 | |
Others | 4 | 2 | 4 | 2 | |
AFP level (ng/mL) | 0.084 | ||||
≤ 400 | 26 | 14 | 18 | 24 | |
> 400 | 32 | 28 | 46 | 25 | |
ALT (U/L) | 0.483 | ||||
≤ 40 | 12 | 8 | 19 | 14 | |
> 40 | 46 | 34 | 45 | 35 | |
AST (U/L) | 0.087 | ||||
≤ 40 | 5 | 2 | 12 | 9 | |
> 40 | 53 | 40 | 52 | 40 | |
VEGF (pg/mL), mean (SD) | 456.06 (216.38) | 412.81 (163.02) | 403.03 (168.45) | 417.99 (170.99) | 0.419 |
Cirrhosis | |||||
No | 0 | 0 | 0 | 0 | |
Yes | 58 | 42 | 64 | 49 | |
Child-Pugh class | 0.102 | ||||
A | 41 | 24 | 49 | 29 | |
B | 17 | 18 | 15 | 20 | |
Tumor size (cm) | 0.103 | ||||
≤ 5 | 34 | 18 | 41 | 23 | |
> 5 | 24 | 24 | 23 | 26 | |
Tumor number | 0.338 | ||||
Single | 21 | 12 | 15 | 11 | |
Multiple | 37 | 30 | 49 | 38 | |
Metastasis | 0.091 | ||||
Yes | 18 | 20 | 16 | 19 | |
No | 40 | 22 | 48 | 30 | |
BCLC stage | 0.471 | ||||
B | 38 | 22 | 35 | 26 | |
C | 20 | 20 | 29 | 23 |
Table 2 Peripheral blood lymphocyte profiles before and after treatment in different combination groups
Type | T + A | T + L | T + S | T + D | ||||||||
Before treatment | After treatment | P value | Before treatment | After treatment | P value | Before treatment | After treatment | P value | Before treatment | After treatment | P value | |
Total T lymphocytes (%) | 78.79 (9.22) | 76.50 (10.59) | 0.260 | 70.71 (10.78) | 71.55 (9.20) | 0.755 | 73.84 (11.88) | 74.44 (9.47) | 0.869 | 72.75 (13.79) | 71.26 (14.45) | 0.606 |
Suppressor/cytotoxic cells (%) | 32.20 (13.03) | 31.82 (14.55) | 0.907 | 28.05 (12.29) | 25.73 (7.82) | 0.490 | 26.74 (12.65) | 26.06 (8.73) | 0.756 | 28.59 (14.91) | 27.07 (13.53) | 0.478 |
Helper/inducible cells (%) | 39.04 (8.31) | 37.98 (7.35) | 0.608 | 40.89 (9.73) | 32.54 (9.74) | 0.003a | 42.05 (8.64) | 44.06 (7.17) | 0.434 | 34.70 (7.35) | 35.93 (5.64) | 0.446 |
Natural killer cell (%) | 12.68 (8.13) | 11.56 (8.28) | 0.505 | 17.13 (8.63) | 16.86 (8.16) | 0.922 | 18.81 (11.28) | 17.56 (9.27) | 0.715 | 16.31 (11.20) | 18.61 (12.75) | 0.261 |
B lymphocytes (%) | 7.20 (4.71) | 9.43 (6.42) | 0.093 | 10.68 (8.34) | 10.82 (5.38) | 0.952 | 5.58 (3.38) | 5.96 (3.23) | 0.707 | 10.30 (6.15) | 10.40 (4.44) | 0.933 |
Helper T cells/suppressor T cells | 1.58 (1.20) | 1.67 (1.27) | 0.659 | 1.79 (1.25) | 1.64 (0.93) | 0.674 | 1.98 (0.99) | 1.86 (0.63) | 0.585 | 1.46 (0.54) | 1.59 (0.61) | 0.198 |
Regulatory cells (%) | 11.65 (3.90) | 11.60 (3.63) | 0.918 | 10.47 (2.60) | 11.79 (2.88) | 0.110 | 10.04 (2.93) | 10.31 (3.11) | 0.789 | 12.23 (4.35) | 10.78 (3.27) | 0.013a |
Proportion of PD-1+ in mononuclei (%) | 2.05 (4.13) | 1.21 (2.89) | 0.045a | 4.45 (6.24) | 2.37 (6.43) | 0.136 | 5.11 (8.10) | 2.66 (6.40) | 0.132 | 1.36 (4.86) | 2.15 (6.24) | 0.533 |
Proportion of PD-1+ in CD3+ cells (%) | 2.43 (5.68) | 1.85 (5.18) | 0.563 | 6.93 (9.04) | 3.79 (8.64) | 0.205 | 6.91 (10.95) | 3.48 (8.89) | 0.071 | 1.69 (6.48) | 2.79 (8.01) | 0.330 |
Proportion of PD-1+ in CD4+ cells (%) | 1.69 (4.39) | 1.72 (5.14) | 0.974 | 6.11 (8.56) | 3.16 (7.42) | 0.144 | 8.06 (12.81) | 3.91 (10.43) | 0.146 | 2.00 (8.42) | 2.62 (7.94) | 0.660 |
Proportion of PD-1+ in CD8+ cells (%) | 3.32 (8.42) | 1.86 (5.36) | 0.262 | 7.92 (11.64) | 4.60 (10.61) | 0.262 | 3.36 (6.86) | 1.98 (7.22) | 0.375 | 1.13 (4.02) | 2.12 (6.05) | 0.292 |
Absolute count of total lymphocytes (/uL) | 1537.33 (650.17) | 1349.96 (534.78) | 0.154 | 1248.86 (442.71) | 1624.48 (602.20) | 0.032a | 1555.82 (503.27) | 1319.00 (374.04) | 0.148 | 1891.05 (784.70) | 1721.86 (466.61) | 0.378 |
Absolute T lymphocyte count (/uL) | 1194.63 (461.58) | 1058.63 (467.70) | 0.223 | 898.57 (347.46) | 1143.43 (436.88) | 0.058 | 1137.41 (484.47) | 976.18 (230.22) | 0.266 | 1251.73 (531.50) | 1270.27 (452.22) | 0.860 |
CD4+T lymphocyte absolute count (/uL) | 625.46 (346.62) | 488.96 (184.78) | 0.027a | 421.43 (38.52) | 603.24 (62.16) | 0.009a | 628.12 (184.95) | 579.65 (173.29) | 0.425 | 627.45 (198.58) | 590.09 (464.05) | 0.700 |
CD8+T lymphocyte absolute count (/uL) | 492.25 (266.83) | 457.58 (368.59) | 0.652 | 379.71 (130.84) | 502.71 (267.30) | 0.023a | 425.24 (327.35) | 340.24 (125.24) | 0.294 | 390.64 (183.19) | 530.18 (169.23) | 0.001a |
Absolute NK cell count (/uL) | 214.25 (217.71) | 156.75 (143.46) | 0.112 | 299.10 (233.67) | 201.76 (113.38) | 0.114 | 333.12 (238.31) | 258.47 (191.34) | 0.323 | 288.41 (223.55) | 384.86 (229.53) | 0.039a |
Absolute B cell count (/uL) | 109.21 (95.35) | 127.29 (89.20) | 0.333 | 178.76 (153.83) | 134.33 (77.23) | 0.285 | 80.18 (46.41) | 74.82 (46.18) | 0.720 | 179.60 (108.93) | 164.73 (93.09) | 0.650 |
Table 3 Univariate and multivariate Cox regression analyses for progression-free survival
Variables | Univariate analysis | Multivariate analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Age | 0.989 (0.968-1.010) | 0.302 | ||
Sex | 0.964 (0.538-1.725) | 0.901 | ||
Etiology | 1.242 (0.537-2.873) | 0.612 | ||
AFP | 1.318 (0.845-2.057) | 0.224 | ||
ALT | 1.002 (0.999-1.005) | 0.309 | ||
AST | 1.001 (0.999-1.003) | 0.518 | ||
VEGF | 1.000 (0.999-1.001) | 0.798 | ||
Child-Pugh class | 1.135 (0.721-1.788) | 0.585 | ||
ECOG score | ||||
0 | 0.925 (0.338-2.534) | 0.880 | ||
1 | 0.980 (0.562-1.708) | 0.943 | ||
Tumor size | 1.011 (1.004-1.019) | 0.002a | 1.009 (1.001-1.017) | 0.023a |
Tumor number | 0.974 (0.860-1.103) | 0.677 | ||
Metastasis | 0.947 (0.578-1.554) | 0.831 | ||
BCLC stage | 1.436 (0.914-2.254) | 0.116 | ||
Treatment methods | ||||
T + A | 0.722 (0.396-1.317) | 0.288 | ||
T + L | 0.608 (0.321-1.152) | 0.608 | ||
T + S | 0.586 (0.300-1.145) | 0.118 | ||
Total T lymphocytes | 0.986 (0.966-1.008) | 0.211 | ||
Suppressor/cytotoxic cells | 0.998 (0.981-1.016) | 0.859 | ||
Helper/inducible cells | 0.976 (0.954-0.998) | 0.033a | 0.982 (0.959-1.006) | 0.133 |
Natural killer cell | 1.016 (0.991-1.043) | 0.210 | ||
B lymphocytes | 1.024 (0.984-1.065) | 0.252 | ||
Helper T cells/suppressor T cells | 1.017 (0.823-1.257) | 0.873 | ||
Regulatory cells | 1.100 (1.033-1.172) | 0.003a | 1.063 (0.989-1.144) | 0.098 |
Proportion of PD-1+ in peripheral blood mononuclei | 1.014 (0.975-1.054) | 0.498 | ||
Proportion of PD-1+ in CD3+ cells | 1.011 (0.984-1.039) | 0.410 | ||
Proportion of PD-1+ in CD4+ cells | 1.010 (0.985-1.037) | 0.435 | ||
Proportion of PD-1+ in CD8+ cells | 0.975 (0.946-0.999) | 0.040a | 0.966 (0.938-0.995) | 0.022a |
Absolute count of total lymphocytes | 1.000 (1.000-1.000) | 0.782 | ||
Absolute T lymphocyte count | 1.000 (0.999-1.000) | 0.451 | ||
Absolute count of CD3+CD4+ lymphocytes | 1.000 (0.999-1.001) | 0.477 | ||
Absolute count of CD3+CD8+ lymphocytes | 0.998 (0.997-0.999) | 0.002a | 0.998 (0.997-0.999) | 0.001a |
CD4/CD8 ratio | 0.934 (0.741-1.177) | 0.564 | ||
Absolute NK cell count | 1.001 (1.000-1.002) | 0.168 | ||
Absolute B cell count | 1.002 (1.000-1.004) | 0.085 |
Table 4 Univariate and multivariate Cox regression analyses for overall survival
Variables | Univariate analysis | Multivariate analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Age | 0.994 (0.972-1.015) | 0.554 | ||
Sex | 1.273 (0.710-2.282) | 0.418 | ||
Etiology | 1.444 (0.619-3.368) | 0.396 | ||
AFP | 1.215 (0.769-1.919) | 0.405 | ||
ALT | 1.062 (0.617-1.827) | 0.828 | ||
AST | 1.002 (1.000-1.004) | 0.064 | ||
VEGF | 1.000 (0.999-1.001) | 0.780 | ||
Child-Pugh class | 0.947 (0.594-1.512) | 0.821 | ||
ECOG score | ||||
0 | 1.029 (0.393-2.690) | 0.954 | ||
1 | 0.884 (0.490-1.595) | 0.683 | ||
Tumor size | 1.011 (1.003-1.020) | 0.005a | 1.010 (1.001-1.016) | 0.032a |
Tumor number | 0.954 (0.842-1.081) | 0.461 | ||
Metastasis | 0.928 (0.556-1.548) | 0.774 | ||
BCLC stage | 1.209 (0.760-1.924) | 0.423 | ||
Treatment methods | ||||
T + A | 0.926 (0.499-1.720) | 0.809 | ||
T + L | 0.781 (0.408-1.492) | 0.453 | ||
T + S | 0.698 (0.358-1.360) | 0.291 | ||
Total T lymphocytes | 0.990 (0.968-1.012) | 0.379 | ||
Suppressor/cytotoxic cells | 0.992 (0.974-1.011) | 0.421 | ||
Helper/inducible cells | 0.999 (0.976-1.021) | 0.903 | ||
Natural killer cell | 1.007 (0.982-1.032) | 0.590 | ||
B lymphocytes | 1.031 (0.988-1.076) | 0.164 | ||
Helper T cells/suppressor T cells | 1.088 (0.885-1.337) | 0.426 | ||
Regulatory cells | 1.082 (1.008-1.161) | 0.029a | 1.074 (1.001-1.152) | 0.046a |
Proportion of PD-1+ in peripheral blood mononuclei | 1.012 (0.972-1.054) | 0.561 | ||
Proportion of PD-1+ in CD3+ cells | 1.011 (0.983-1.041) | 0.432 | ||
Proportion of PD-1+ in CD4+ cells | 1.007 (0.981-1.034) | 0.618 | ||
Proportion of PD-1+ in CD8+ cells | 0.989 (0.963-1.015) | 0.402 | ||
Absolute count of total lymphocytes | 1.000 (1.000-1.000) | 0.612 | ||
Absolute T lymphocyte count | 1.000 (0.999-1.000) | 0.784 | ||
Absolute count of CD3+CD4+ lymphocytes | 1.000 (0.999-1.001) | 0.926 | ||
Absolute count of CD3+CD8+ lymphocytes | 0.999 (0.998-1.000) | 0.096 | ||
CD4/CD8 ratio | 0.992 (0.795-1.239) | 0.945 | ||
Absolute NK cell count | 1.000 (0.999-1.001) | 0.527 | ||
Absolute B cell count | 1.003 (1.001-1.005) | 0.017a | 1.002 (1.000-1.004) | 0.108 |
- Citation: Guo Y, Li RC, Xia WL, Yang X, Zhu WB, Li FT, Hu HT, Li HL. Immune effect and prognosis of transcatheter arterial chemoembolization and tyrosine kinase inhibitors therapy in patients with hepatocellular carcinoma. World J Gastrointest Oncol 2024; 16(7): 3256-3269
- URL: https://www.wjgnet.com/1948-5204/full/v16/i7/3256.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v16.i7.3256