Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 104923
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.104923
Clinical significance of immune cell and biomarker changes in liver cancer
Su-Tao Zhou, Bin Zhang, Ke Ma, Juan Guo
Su-Tao Zhou, Bin Zhang, Ke Ma, Juan Guo, Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China
Author contributions: Zhou ST contributed to the conception and design of the study, as well as the data acquisition and analysis; Zhang B, Ma K, and Guo J assisted with the data collection; Zhou ST and Zhang B analyzed the data and wrote the manuscript; All authors read and approved the final version.
Institutional review board statement: This study was approved by the Ethics Committee of The First Affiliated Hospital of Hebei North University (No. K2025001).
Informed consent statement: The data used in this study were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of The First Affiliated Hospital of Hebei North University.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: No additional data are available.
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: Su-Tao Zhou, Department of Laboratory Medicine, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Zhangjiakou 075000, Hebei Province, China. zjkzhousutao@163.com
Received: February 12, 2025
Revised: March 13, 2025
Accepted: May 6, 2025
Published online: June 27, 2025
Processing time: 107 Days and 3.2 Hours
Abstract
BACKGROUND

Primary liver cancer (PLC) is characterized by high malignancy, rapid disease progression, and persistent high incidence and mortality rates, posing a significant public health challenge worldwide. Early diagnosis and assessment of PLC are of great significance for guiding clinical treatment and improving patient prognosis. Alpha fetoprotein (AFP) and gamma-glutamyl transpeptidase (GGT) are commonly utilized tumor markers for the clinical diagnosis of PLC. They are ideal indicators for the detection of metastasis and recurrence after LC surgery. Nevertheless, not all patients with PLC secrete large amounts of AFP and GGT, which affects the accuracy of evaluating PLC by monitoring these two tumor markers alone. Cluster of differentiation 3 and 161 double-positive natural killer T (CD3+CD161+NKT) cell subsets are a class of molecules inextricably related to immune function and tumor occurrence and development. This research seeks to explore the clinical significance of CD3+CD161+NKT cell subsets combined with tumor markers AFP and GGT in the diagnosis of patients with PLC.

AIM

To probe the clinical significance of CD3+CD161+NKT cell subsets and AFP and GGT changes in the peripheral blood of individuals with PLC.

METHODS

The PLC group comprised 30 patients diagnosed with PLC who were admitted to our hospital between July 2022 and December 2023, whereas the control group consisted of 30 healthy individuals undergoing routine physical examinations at our hospital. Peripheral blood samples were harvested from both cohorts of patients. The levels of CD4+NKT, CD8+NKT, CD3+CD56+NKT, CD8+CD56+NKT, CD3+CD161+NKT, and CD3-CD161+NKT were measured by flow cytometry. Serum AFP content was determined using a fully automatic immunoassay analyzer, and serum GGT content was ascertained by a fully automatic biochemical analyzer. The diagnostic value of CD3+CD161+NKT cell subsets and AFP and GGT level alterations for PLC was evaluated by receiver operating characteristic curve analysis.

RESULTS

No significant disparities were observed in the counts of white blood cells, neutrophils, and platelets, as well as the levels of blood urea nitrogen and serum creatinine between the two groups (P > 0.05). Lymphocytes, red blood cells, hemoglobin, total protein, albumin, and globulin were more attenuated in the PLC group than in the control group, while glutamic-pyruvic transaminase, glutamic oxalacetic transaminase, and carcinoembryonic antigen levels were increased in the PLC cohort compared with the control cohort, with statistical significance (P < 0.05). No substantial difference was discovered in peripheral blood CD4+NKT, CD8+NKT, and CD3+CD56+NKT cells between the two cohorts (P > 0.05). The percentage of CD8+CD56+NKT cells (8.35% ± 1.01%), CD3+CD161+NKT cells (14.36% ± 1.55%), and CD3-CD161+NKT cells (12.08% ± 1.34%) in the PLC group was higher than that in the control group (P < 0.05). The levels of AFP (335.71 ± 20.89 ng/mL) and GGT (136.87 ± 15.62 U/mL) in the PLC cohort were elevated within the PLC cohort compared with the control cohort (P < 0.05). The sensitivity of CD8+CD56+NKT, CD3+CD161+NKT, CD3-CD161+NKT, AFP, and GGT alone for diagnosing PLC was 70.00%, 83.33%, 80.00%, 56.67%, and 53.33%, respectively (P < 0.05), with specificity rates of 66.67%, 80.00%, 76.67%, 76.67%, and 66.67%, respectively (P < 0.05). The area under the curve for combined detection was 0.898, with a sensitivity of 86.67% and a specificity of 80.00% (P < 0.05).

CONCLUSION

The levels of CD8+CD56+NKT, CD3+CD161+NKT, CD3-CD161+NKT, AFP, and GGT in the peripheral blood of patients with PLC were markedly elevated. The combined detection of these five indicators can improve the sensitivity and specificity of PLC diagnosis, providing solid evidence for the early clinical diagnosis of PLC.

Keywords: Primary liver cancer; Cluster of differentiation 3; Cluster of differentiation 8; Cluster of differentiation 56; Cluster of differentiation 161; Natural killer T cells; Alpha fetoprotein; Gamma-glutamyl transpeptidase

Core Tip: This investigation determined cluster of differentiation 4-positive (CD4+), CD8+, CD3+CD56+, CD8+CD56+, CD3+CD161+, and CD3-CD161+ natural killer T (NKT) cell, alpha fetoprotein (AFP), and gamma-glutamyl transpeptidase (GGT) levels in the peripheral blood samples of patients with primary liver cancer (PLC) and healthy individuals. The aim was to confirm the diagnostic value of NKT cell subsets, AFP, and GGT levels in the context of PLC. The results revealed a marked increase in the levels of CD8+CD56+NKT, CD3+CD161+NKT, CD3-CD161+NKT, AFP, and GGT in patients with PLC. Combining these five indicators for detection enhances the sensitivity and specificity of PLC diagnosis.