Prognostic Value of Soluble Programmed Death Ligand-1 (sPD-L1) in Hepatocellular Carcinoma


The Department of Hepatology, Gastroenterology & Infectious Diseases* and Clinical Pathology**, Faculty of Medicine, Benha University


Abstract Background: Hepatocellular carcinoma (HCC) is the fifth most commonly occurring cancer worldwide and the third cause of mortality due to cancer. Many clinical and laboratory findings used to assess prognosis of HCC. Different studies had been performed to investigate the prognostic value of sPD-L1 in HCC progression. Aim of Study: To assess serum level of sPD-L1 in patients of HCC and to detect its role in HCC prognosis. Subjects and Methods: This case-control study was con-ducted on 80 subjects divided into 2 groups (1st group) 60 patients with HCC diagnosed by 2 imaging techniques and elevated alpha feto-protein and (2nd group) include age and sex matched 20 healthy subjects. All the patients were evaluated by thorough full history taking, clinical examination, routine laboratory investigations including alpha feto-protein (AFP) and sPD-L1 measured by ELISA with calculation of MELD score and albumin/bilirubin score (ALBI), Imaging by abdom-inal ultrasound and triphasic CT scan, and assessment of HCC stage using Barcelona Clinic Liver Cancer (BCLC). Results: There were highly statistically significant varia-tions in sPD-L1 level according to the stage of HCC and vascular infiltration. Logistic regression analysis showed that sPD-L1 (odd ratio (OR) 1.01; 95% confidence interval (CI) was 1.003 to 1.03) and AFP (OR 1.01: 95% CI was 1 to 1.01) were significant independent predictors for occurrence of HCC (stage C & D versus stages A & B). sPD-L1 cut off value that diagnose the advanced HCC stages (C & D) was 586 (pg/ml) with sensitivity 80% and specificity 62.5% with area under ROC curve is 0.79, and at cut off level 1325 (pg/ml) sensitivity was 100%, specificity 94% and area under ROC curve was 0.97. Conclusion: sPD-L1 has a good diagnostic and prognostic value in the diagnosis of HCC.