外周血 CD4(+) T 细胞和 NK 细胞对接受免疫治疗的晚期 HCC 患者疗效及长期生存的预测价值

Early assessment of the efficacy of immune checkpoint inhibitor (ICI) therapy in advanced hepatocellular carcinoma (HCC) patients plays a crucial role. In this study, we systematically analyzed the predictive values of various lymphocyte subpopulations (CD4 + T, CD8 + T, and NK cells) at different time points of pretreatment (W0), 3 weeks (W3) and 6 weeks (W6) post-treatment and their relative changes compared to W0 for objective response (OR).

We systematically reviewed the clinical data of these patients in our hospital. Logistic regression analyses were conducted to identify variables predicting OR. Cut-off values were determined by maximizing Youden index. Then, patients were stratified based on these cut-off values, and Kaplan-Meier analysis with log-rank test was used to compare progression-free survival (PFS) and overall survival (OS) between groups.

A total of 41 patients were included. Multivariate logistic regression analysis revealed that W3 CD4 + T cells (%) and W3 NK cells(%) were independent predictors of treatment efficacy. The odds ratios (95% confidence interval) and p-values were 1.140 (1.020-1.274), 0.021 and 2.232 (1.025-4.860), 0.043, respectively. Combining these two indicators yielded even better performance: all patients in the "All High" group achieved OR, whereas none in the "All Low" group did. Furthermore, whether used individually or in combination, they all could stratify patients by PFS and OS.

W3 CD4 + T cells (%) and W3 NK cells (%) can predict the efficacy and long-term survival (PFS and OS) of these patients. Their combination offers improved predictive performance.