Clinicopathological implications of FGL1, PD-L1 and CMTM6 expressions in hepatocellular carcinoma and their correlation to patients' survival

Background: FGL1 (Fibrinogen-like-protein 1), is synthesized by the liver .It was over-expressed in HCC. It triggers metabolism and promotes tissue proliferation .T cell are down regulated by PD-1 binding which is present on cell surface of malignant hepatocyte in HCC. Checkpoint inhibitors (anti-PD-1/PDL-1 antibodies) control tumors immune by enforcing anti-tumor T cell responses. CMTM6 controls expression of PD-L1 in malignancy against T lymphocytes.. CMTM6 inhibition of might augment the effect of PD-L1 blocking pathway.It also plays a role in the process of EMT.Aim of study: The current study explore the relation between FGL1, PD-L1, CMTM6 and HCC prognosis and it’s outcome, which could help in novel treatments development against HCC. Moreover, it investigates the relation between expression of PD-L1 and CMTM6 by IHC.Patients And Methods: This is a prospective cohert study included Sixty cases of hepatocellular carcinoma where they operated at Surgery Department, Zagazig University Hospitals by hepatic resection. HCC tissue microarray (TMA) sections consequently exposed to all steps of IHC technique.Results: FGL1,PD-L1 and CMTM6 are significantly correlated with most of the worse clinicopathologic criteria and clinical outcome ,as well ,as OS was shorter for all of the three markers in the current study.Conclusion: The three biomarkers FGL1, PD-L1 and CMTM6 are related to poor prognostic factors of HCC and can be considered as worse outcome indicators. There is an association between both PDL1 and CMTM6, so dual blockage of both markers could be beneficial in preventing tumor progression and low survival rate in HCC patients