PD-1/PD-L1 Expression and Predictive Value of Efficacy in HCC Patients with Anti-PD1 Therapy: A Real-World Study

Background/Objectives The conclusions regarding PD-1/PD-L1 expression and its role as a predictive biomarker for treatment efficacy had been inconsistent in previous clinical trials of PD-1 monoclonal antibodies therapy for hepatocellular carcinoma (HCC). Therefore, this study aimed to analyze the expression of PD-1/PD-L1 in HCC patients treated with PD-1 in real-world settings and to evaluate its predictive value for treatment outcomes. Methods : A retrospective study was conducted on 59 pathologically confirmed HCC patients. PD-1/PD-L1 expression in tumor tissues was assessed via immunohistochemical staining. Clinical characteristics, laboratory parameters, pathological features, and therapeutic outcomes were compared between two groups. Results : Among 59 patients, 12 (20.33%) were PD-1-positive and 18 (30.51%) were PD-L1-positive. The PD-1-positive group exhibited a higher incidence of lymph node metastasis (41.7% vs. 14.9%, P = 0.040) and lower neutrophil counts (3.32 ± 1.19 vs. 4.02 ± 2.22, P = 0.020) compared to the negative group. The PD-L1-positive group showed increased lymph node metastasis (41.2% vs. 14.3%, P = 0.024), reduced platelet counts (136.41 ± 38.18 vs. 148.17 ± 64.13, P = 0.020), higher proportions of poorly differentiated histology (91.7% vs. 44.7%, P = 0.002), and elevated Ki67 expression (54.2 ± 29.3 vs. 37.8 ± 22.4, P = 0.039). However, no significant differences were observed in objective response rate or progression-free survival between PD-1/PD-L1 positive and negative groups(P>0.05). Conclusions : PD-1/PD-L1 expression in HCC tissues is associated with distinct clinicopathological features but demonstrates no significant predictive value for anti-PD-1 therapy efficacy.