Overexpression of mRNA Leukocyte-Associated Immunoglobulin-Like Receptor 2 (LAIR-2) Levels Correlates With Immune Cell Subtype Infiltration, T Cell Exhaustion, and Its Prognostic Potential in Hepatocellular Carcinoma

The immunological microenvironment in hepatocellular carcinoma (HCC) is characterized by impaired immune responses. Significantly, LAIR-2 levels correlate with immune cell subtype infiltration, T cell exhaustion, and its prognostic potential in HCC. This study aims to assess the diagnostic and prognostic significance of expression levels of Pax8-AS1 and LAIR-2 in patients with HCV and their association with susceptibility to HCC. Pax8-AS1 and LAIR-2 expression levels in the serum of patients were analyzed using reverse transcription-quantitative PCR (RT-PCR), while the efficacy of biomarkers in prognostic prediction was assessed by using bioinformatics. The current research showed that Pax8-AS1 had low expression levels in the blood and a positive correlation with portal vein diameter in HCC, which is predictive of portal vein thrombosis (PVT) development. The expression levels of LAIR-2 were elevated in HCV and HCC cases. In HCC, there was an inverse correlation among LAIR-2 and hematology laboratory tests, albumin, tumor nodules, ascites, and splenomegaly. However, there was a positive correlation among LAIR-2, spleen diameter, AFP, and bilirubin. Pax8-AS1 and LAIR-2 showed remarkable diagnostic efficacy, with sensitivity and specificity values, respectively (p < 0.001) (80%, 80% and 90%, 100%) in HCV and (96.7%, 80% and 93%, 100%) in HCC. LAIR-2 overexpression positively correlates with several critical genes associated with exhausted T cells immune infiltration, T cells, CD4+, and CD8+ T cells. The present data support a novel diagnostic and prognostic function for LAIR2 and PAX8-AS1 in HCC, and its significant association with T cell exhaustion contributes to its promotion in HCC. LAIR-2 detection could provide a new prognosis prediction method, and regulation within T-cell exhaustion, optimizing anti-HCC treatments.