HCC通常被晚期诊断出来，只能进行姑息治疗。因此，我们尝试使用不同的免疫标志物来鉴定AFP正常的患者早期HCC。本研究对112名参与者进行了调查，分为两个相等的组：第一组是56名肝硬化和不同阶段HCC的患者，第二组是56名肝硬化患者。HCC的诊断基于AASLD指南。 TNM和BCLC分类系统用于HCC的分期。发现在HCC患者中明显减少了淋巴细胞亚群（CD3+，CD4+，CD8+，CD19+）和NK细胞百分比（CD56+）的中位数（所有P＜0.001）。在HCC组中，中位数单核细胞亚群CD14+ CD16-经典型，CD14++CD16+中间型和CD14-+ CD16++非经典型分别为11.7、4.0和3.5，与肝硬化组相比显著降低（所有P＜0.001）。晚期病（BCLC C和D）的患者比早期病（BCLC A和B）的患者更有可能具有显著更高的CD33+中位数（P=0.05）；此外，在HCC病例组中，患有晚期疾病（BCLC C和D）的患者HLA DR+淋巴细胞百分比的中位数为21.8，早期疾病的患者为13.1（P=0.04）。晚期病（TNM III）的患者比早期病（TNM I和II）的患者更有可能具有显著更高的中位数CD14+ CD16-经典型单核细胞亚群、CD36+HLA DR+和CD36+ CD16-。AFP正常的HCC患者明显减少了淋巴细胞、自然杀伤细胞和所有单核细胞亚群。此外，晚期HCC患者显示出增加的CD33+和HLA DR+淋巴细胞百分比，CD14+ CD16-经典型单核细胞亚群、CD36+HLA DR+和CD36+ CD16-，与早期HCC患者相比。 © 2023 Osman等。

HCC is frequently diagnosed late, when only palliative treatment is available. So, we try to use different immunological markers to identify early HCC in patients with unremarkable raised AFP.This study was conducted on 112 participants divided into two equal groups: Group I, 56 patients with liver cirrhosis and different stages of HCC; Group II, 56 patients with liver cirrhosis. The diagnosis of HCC was based on AASLD guidelines. TNM and BCLC classification systems are used for staging of HCC.A significant reduction in the median percentage of lymphocyte subset (CD3+, CD4+, CD8+, CD19+) and NK cell percentage (CD56+) has been detected in HCC patients (all P < 0.001). In the HCC group the median monocyte subpopulations CD14+ CD16- Classical, CD14++ CD16+ Intermediate, and CD14-+ CD16++ Non-Classical were 11.7, 4.0, and 3.5, respectively, with marked reduction compared with liver cirrhosis group (all P < 0.001). Patients with advanced stages (BCLC C and D) were more likely to have significantly higher median CD33+ than patients with early stages (BCLC A and B) (P = 0.05); also, the median levels of HLA DR+ lymphocytes % in the HCC case group were 21.8 in patients with advanced disease (BCLC C and D) and 13.1 in patients with early stages of the disease (P = 0.04). Patients with late stage (TNM III) were more likely to have significantly higher median CD14+ CD16- Classical monocyte subset, CD36+ HLA DR+, and CD36+ CD16- than patients with early stages (TNM I and II).Patients with HCC with unremarkable raised AFP showed marked reduction in lymphocytes, natural killer cells, and all monocyte subpopulations. In addition, patients with advanced HCC showed increased CD33+ and HLA DR+ lymphocytes %, CD14+ CD16- Classical monocyte subset, CD36+ HLA DR+, and CD36+ CD16- compared with patients with early stages of HCC.© 2023 Osman et al.