Abstract
Hepatocellular carcinoma (HCC) is a globally prevalent malignancy with a high recurrence rate, significantly impacting prognosis and survival. This study aims to identify prognostic molecular markers using single-cell sequencing of tumors and adjacent tissues in primary and recurrent HCC patients. We analyzed single-cell sequencing data from tumor and adjacent normal tissues of primary and recurrent HCC cases to compare immune cell quantity and gene expression profiles. Recurrent HCC patients exhibited a significant reduction in infiltrating NK cells expressing KIR3DL2. Pseudotemporal and cell communication analyses revealed these KIR3DL2high NK cells were in a quiescent state, suggesting NK cell exhaustion and poor prognosis. KIR3DL2 expression in peripheral blood NK cells correlated with that in tissues, highlighting its potential as a prognostic marker for HCC.