Comprehensive Analysis of Imaging Features, Immunohistochemistry and Prognosis of Hepatocellular Carcinoma Patients with Human Immunodeficiency Virus

Background: This study aims to provide clues for the preoperative and prognostic assessment of hepatocellular carcinoma (HCC) patients with human immunodeficiency virus (HIV) by comparing the imaging characteristics, immunohistochemistry and prognosis of HCC patients with and without HIV infection.Methods: The study reviewed two databases, one for HIV-HCC patients and the other for HCC patients who were not infected with HIV. The inclusion criteria were surgically resected and pathologically diagnosed hepatocellular carcinoma patients from October 2013 to August 2016. This study collected 11 HIV-HCC patients (11 men; median age 45 years old, age range 33~71 years) and 11 HCC patients without HIV infection (11 men; median age 50 years old, age range 42~61 years). The image characteristics of HCC were analysed by computed tomography (CT) imaging. In addition, samples were obtained from resected specimens for immunohistochemical analysis, and the expression of glypican-3 (GPC-3), CD34 and Ki-67 were measured. The independent-samples t test, Fisher exact test and Wilcoxon test were used for comparisons. Kaplan-Meier plots were used for postoperative recurrence-free survival analysis.Results: The median diameter of the largest nodule was significantly larger in the HIV-HCC patients than in the HCC group (P=0.027). In addition, the HIV-HCC patients presented significantly higher CD34 and GPC-3 expression than the HCC patients (P=0.031, 0.007, respectively). Moreover, the postoperative recurrence-free survival time was significantly shorter in the HIV-HCC patients than in the HCC patients (Log-Rank test, c2=6.076, P=0.014), with respective median durations of 4 months and 28 months, respectively. Multivariate Cox model analysis revealed that GPC-3 expression and tumour size were independent prognosis factors in the HCC patients (HR = 4.506, 95% CI :1.247-16.278, P= 0.022; HR = 1.479, 95% CI :1.137-1.923, P = 0.022, respectively).Conclusion: Compared to HCC patients with non-HIV infection, HIV-HCC patients frequently present a larger tumour size and high expression of CD34 and GPC-3, which result in shorter postoperative recurrence-free survival. Observing the tumour expression of CD34, GPC-3, and Ki-67 and imaging characteristics could be helpful in providing a basis for the choice of treatment strategies and the prognosis evaluation of patients.