Gram-negative bacteria and endotoxins promote hepatocellular carcinoma progression through the recruitment of myeloid-derived suppressor cells

doi:10.3748/wjg.118794

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jul 21, 2026; 32(27): 118794
Published online Jul 21, 2026. doi: 10.3748/wjg.118794

Table 1 List of clinical characteristics for 93 validation hepatocellular carcinoma cohort

Characteristic	LPS^low (n = 47)	LPS^high (n = 46)	P value¹
Age (year)	56.39 ± 2.48	58.45 ± 2.06	0.409
Gender
Female	6	9	0.373
Male	41	37
OS status
Alive	36	24	0.014^a
Death	11	22
RFS status
None-recurrence	28	17	0.029^a
Recurrence	19	29
TNM stage
I-II	39	29	0.03^a
III-IV	8	17
Grade
I-II	26	15	0.027^a
III-IV	21	31
MVI
No	33	25	0.114
Yes	14	21
Size (cm)
≤ 5	14	12	0.691
> 5	33	34
Child-Pugh
A	41	32	0.038^a
B	6	14

^aP < 0.05.

¹χ² test used to calculate the P values.

LPS: Lipopolysaccharide; OS: Overall survival; RFS: Recurrence-free survival; MVI: Microvascular invasion.

Full Size Table

Table 2 Independent prognostic factors predicting overall survival in 93 validation hepatocellular carcinoma cohort

Characteristic	Univariate analysis [HR (95%CI)]	P value	Multivariate analysis [HR (95%CI)]	P value
Age (year)
< 57/≥ 57	0.71 (0.36-1.4)	0.24
Gender
Female/male	1.56 (0.47-5.18)	0.464
Child-Pugh
Grade A/B	2.25 (1.09-4.67)	0.029^a	0.6 (0.27-1.32)	0.205
Tumor diameter (cm)
≤ 5/> 5	2.73 (1.05-7.09)	0.039^a	0.64 (0.22-1.84)	0.405
MVI
Yes/no	3.32 (1.57-7.01)	0.002^a	0.32 (0.15-0.7)	0.004^b
TNM stage
I-II	3.09 (1.55-6.15)	0.001^a	0.59 (0.26-1.33)	0.201
III-IV
Edmondson-Steiner grading
I-II
III-IV	2.73 (1.28-5.82)	0.01^a	0.63 (0.27-1.46)	0.282
LPS
Low/high	0.32 (0.15-0.67)	0.002^a	2.41 (1.13-5.15)	0.023^a

^aP < 0.05.

^bP < 0.01.

LPS: Lipopolysaccharide; MVI: Microvascular invasion.

Full Size Table

Table 3 List of clinical characteristics for 30 validation hepatocellular carcinoma cohort

Characteristic	LPS^low (n = 16)	LPS^high (n = 14)	P value¹
Age (year)	53.88 ± 3.8	60 ± 2.47	-
Gender
Female	4	3	-
Male	12	11
OS status
Alive	14	10	-
Death	2	4
RFS status
None-recurrence	14	7	0.046^a
Recurrence	2	7
TNM Stage
I-II	12	9	-
III-IV	4	5
Grade
I-II	10	7	-
III-IV	6	7

^aP < 0.05.

¹χ² test used to calculate the P values.

LPS: Lipopolysaccharide; OS: Overall survival; RFS: Recurrence-free survival.

Full Size Table

Citation: Zhang Y, Zhou YL, Nie X, Zhang LJ, Xu WW, Wang JQ, Zhao HL, Xu JK, Xu J, Xu HM, Li JH, Huang WQ, Yang J, Yang YX, Zhan Q, Lin Y, Nie YQ. Gram-negative bacteria and endotoxins promote hepatocellular carcinoma progression through the recruitment of myeloid-derived suppressor cells. World J Gastroenterol 2026; 32(27): 118794
URL: https://www.wjgnet.com/1007-9327/full/v32/i27/118794.htm
DOI: https://dx.doi.org/10.3748/wjg.118794

Zhang Y, Zhou YL, Nie X, Zhang LJ, Xu WW, Wang JQ, Zhao HL, Xu JK, Xu J, Xu HM, Li JH, Huang WQ, Yang J, Yang YX, Zhan Q, Lin Y, Nie YQ. Gram-negative bacteria and endotoxins promote hepatocellular carcinoma progression through the recruitment of myeloid-derived suppressor cells. World J Gastroenterol 2026; 32(27): 118794 [DOI: 10.3748/wjg.118794]

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