Multimodal clinical parameters-based immune status associated with the prognosis in patients with hepatocellular carcinoma

Figure 1 Exploring the relationship between immune status and prognosis of hepatocellular carcinoma with multimodal clinical parameters. Hepatocellular carcinoma patients present with three distinct immune profiles (“immune-desert”, “immune-excluded”, and “immune-inflamed”), corresponding to divergent prognostic outcomes (poor vs good). Clinical features, routine blood test, immune cell subsets, imaging features and immunochemical markers were used to indicate the different immune status of hepatocellular carcinoma patients, and collected and analyzed their prognostic effects. HCC: Hepatocellular carcinoma; ECOG-PS: Eastern Cooperative Oncology Group-performance status; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; APAR: Alkaline phosphatase to albumin ratio; GGT: Gamma-glutamyl transferase; LDH: Lactate dehydrogenase; RBC: Red blood cell; WBC: White blood cell; LCR: Lymphocyte-to-C-reactive protein ratio; NLR: Neutrophil-to-lymphocyte ratio; PLT: Platelet; PLR: Platelet-to-lymphocyte ratio; CRP: C-reactive protein; IL: Interleukin; TGF-β: Transforming growth factor-β; DC: Dendritic cell; TAM: Tumor-associated macrophage; MDSC: Myeloid-derived suppressor cell; NK: Natural killer cell; Treg: Regulatory T cell; Th: T helper cell; NKT: Natural killer T cell; CT: Computed tomography; MR: Magnetic resonance; DSA: Digital subtraction angiography; MVI: Microvascular invasion; VLP: Vascular invasion-like pattern; AFP: Alpha-fetoprotein; AFP-L3: Alpha-fetoprotein L3 fraction; DCP: Des-gamma-carboxy prothrombin; CK19: Cytokeratin 19; GP73: Golgi protein 73; PD1: Programmed cell death protein 1; PD-L1: Programmed death-ligand 1; PD-L2: Programmed death-ligand 2; MMPs: Matrix metalloproteinases; CTLA-4: Cytotoxic T-lymphocyte-associated protein 4; TIM-3: T-cell immunoglobulin and mucin-domain containing-3; LAG-3: Lymphocyte-activation gene 3.

Figure 2 Evaluation of immunohistochemical markers in prognostic risk stratification for hepatocellular carcinoma. By analyzing the expression patterns of key immune checkpoints and biomarkers in the tumor microenvironment, the prognostic risks of HCC were classified into three categories: High risk, intermediate risk, and protective factors. PD-L1: Programmed death-ligand 1; PD-1: Programmed cell death protein 1; TIM-3: T-cell immunoglobulin and mucin-domain containing-3; MMP: Matrix metalloproteinase; DCP: Des-gamma-carboxy prothrombin; GP73: Golgi protein 73; AFP: Alpha-fetoprotein; AFP-L3: Alpha-fetoprotein L3 fraction; LAG-3: Lymphocyte-activation gene 3.

Figure 3 Future prospects of study design and statistic method for prognostic prediction of hepatocellular carcinoma patients based on analysis of multimodal clinical parameters. Based on the multimodal clinical parameters, follow-up studies will center on four key areas: Observation studies, clinical trials, prognosis analyses, and clinical decision tools. Diverse statistical methods, covering linear and nonlinear models as well as machine learning and deep learning models, can be applied for achieving comprehensive and in-depth research results.