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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Feb 24, 2026; 17(2): 114622
Published online Feb 24, 2026. doi: 10.5306/wjco.v17.i2.114622
Published online Feb 24, 2026. doi: 10.5306/wjco.v17.i2.114622
T cell exhaustion markers in hepatitis C virus-related hepatocellular carcinoma: Expression patterns and prognostic significance in an Egyptian cohort
Asmaa M Hasan, Sara M F I Ghanem, Nahla Nosair, Department of Clinical Pathology, Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh 33511, Egypt
Amira A A Othman, Department of Internal Medicine, Faculty of Medicine, Suez University, Suez 43511, Egypt
Mai Hamdy Rashad, Medical Microbiology and Immunology, Faculty of Medicine, Suez Uni
Rasha Elgamal, Department of Clinical Pathology, Faculty of Medicine, Suez University, Suez 43511, Egypt
Author contributions: Hasan AM drafted the manuscript; Hasan AM, Ghanem SMFI, Othman AAA, Rashad MH, and Nosair NA acquired and analyzed the data; Hasan AM, Ghanem SMFI, Othman AAA, Rashad MH, Nosair NA, and Elgamal R conceived and designed the research study; Hasan AM and Othman AAA performed the statistical analysis and interpreted the results; Ghanem SMFI, Othman AAA, Rashad MH, Nosair NA, and Elgamal R critically revised the manuscript. All authors approved the final version to be published and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study received approval from the Scientific Research Ethics Committee of Kafrelsheikh University (Approval No. KFSIRB200-712). All methods were carried out according to relevant guidelines and regulations. The study was conducted following the principles of Good Clinical Practice and the Declaration of Helsinki.
Informed consent statement: All subjects were informed and gave their voluntary, written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All relevant data are included in this published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amira A A Othman, Department of Internal Medicine, Faculty of Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt.
Received: September 24, 2025
Revised: October 11, 2025
Accepted: December 18, 2025
Published online: February 24, 2026
Processing time: 135 Days and 11.4 Hours
Revised: October 11, 2025
Accepted: December 18, 2025
Published online: February 24, 2026
Processing time: 135 Days and 11.4 Hours
Core Tip
Core Tip: Hepatocellular carcinoma linked to hepatitis C virus (HCV) is a major health burden in Egypt. This study comprehensively evaluated T cell exhaustion markers, programmed death 1, T cell immunoglobulin and ITIM domain, and T cell immunoglobulin and mucin domain-containing protein 3, on CD4+ and CD8+ T cells across HCV-related liver disease stages. Using advanced analyses, including Random Forest modeling, Cox regression, and mediation analysis, we identified CD4 programmed death 1 and CD8/T cell immunoglobulin and mucin domain-containing protein 3 as robust prognostic biomarkers of poor survival. These findings highlight novel immune targets for risk stratification and potential immunotherapy in HCV-related hepatocellular carcinoma.