To investigate the relationship between programmed cell death 4 (PDCD4) and disease progression after hepatectomy in patients with primary hepatocellular carcinoma (HCC).

A total of 130 HCC patients who underwent surgical resection from May 2022 to January 2024 were selected. The expression of PDCD4 in cancer tissues was detected by immunohistochemistry, and its relationship with clinicopathological characteristics of HCC patients was analyzed. Survival analysis was performed using the Kaplan-Meier method, and univariate and multivariate COX regression analyses were used to identify influencing factors of disease progression after hepatectomy in HCC patients.

The low expression rate of PDCD4 in HCC tissues was 60.0%, and the high expression rate was 40.0%. Low PDCD4 expression was correlated with CNLC stage, differentiation degree, and vascular invasion (P<0.05). The 1-year postoperative recurrence rate in the low PDCD4 expression group was 33.3%, which was higher than 9.6% in the high PDCD4 expression group (P<0.05). Kaplan-Meier analysis showed that the median 1-year postoperative progression-free survival (PFS) in the low PDCD4 expression group was 6 months, which was significantly shorter than 9 months in the high PDCD4 expression group (P<0.05). The 1-year postoperative PFS rate in the low PDCD4 expression group was 66.7%, which was lower than 90.4% in the high PDCD4 expression group (P<0.05). Univariate analysis showed that tumor diameter, CNLC stage, differentiation degree, vascular invasion, and PDCD4 expression were associated with postoperative PFS in HCC patients (P<0.05). Multivariate COX regression analysis revealed that CNLC stage Ⅲ (HR=1.923, 95%CI: 1.282-2.889), vascular invasion (HR=2.331, 95%CI: 1.254-4.358), and low PDCD4 expression (HR=3.454, 95%CI: 1.781-6.688) were independent risk factors for postoperative PFS in HCC patients (P<0.05).

Low PDCD4 expression is closely related to disease progression after hepatectomy in HCC patients and serves as a potential biomarker for evaluating the risk of disease progression after hepatectomy in HCC patients. Detecting the expression level of PDCD4 is expected to provide a reference for clinical treatment decision-making.