T cell exhaustion markers in hepatitis C virus-related hepatocellular carcinoma: Expression patterns and prognostic significance in an Egyptian cohort

Figure 3 Immune checkpoint correlations with disease severity in hepatocellular carcinoma patients. Lollipop plot (forest plot variant) displaying Pearson correlation coefficients for Model for End-Stage Liver Disease (MELD) score and Spearman correlation coefficients for Child-Pugh class, alpha-fetoprotein, and Barcelona Clinic Liver Cancer stage between immune cell subsets and clinical severity markers in hepatocellular carcinoma patients (n = 50). Points indicate correlation estimates (red = positive association, blue = negative association; point size is proportional to the absolute value of the correlation coefficient |r|), with horizontal lines marking 95% confidence intervals. Key findings: (1) Strong negative correlations between programmed death-1 T cell immunoglobulin and mucin domain-containing protein 3 T-cell immunoglobulin and ITIM domain expression and MELD score (e.g., CD4/programmed death-1: r = -0.73, P < 0.001); (2) Consistent positive correlations with Child-Pugh class and Barcelona Clinic Liver Cancer stage (e.g., CD4/T cell immunoglobulin and mucin domain-containing protein 3: r = 0.86, P < 0.001); and (3) Inverse correlation patterns for the CD4/CD8 ratio (MELD: r = 0.75, P < 0.001 vs Child-Pugh: r = -0.84, P < 0.001). ^aP < 0.001 after adjustment for age and sex. TIM-3: T cell immunoglobulin and mucin domain-containing protein 3; TIGIT: T-cell immunoglobulin and ITIM domain; AFP: Alpha-fetoprotein; BCLC: Barcelona Clinic Liver Cancer; MELD: Model for End-Stage Liver Disease; HCC: Hepatocellular carcinoma.