Abstract
Hepatocellular carcinoma (HCC) represents the predominant form of primary liver cancer, constituting 75%-85% of all liver cancer cases. Despite advances in understanding HCC mechanisms and treatment options, challenges remain and further research is needed to uncover new therapeutic targets and improve patient outcomes. intraoperative cell salvage (IOCS) is an important surgical method that minimises the necessity for transfusions of donor blood, improves haemodynamic stability and may enhance recovery. This study aims to identify safety biomarkers for autologous blood transfusion in HCC patients. We conducted a prospective case-control study on 80 HCC patients undergoing radical surgery. Blood and tumour tissues were collected for analysis. The control group provided blood directly from the surgical site without IOCS processing, while the experimental group used blood collected through the IOCS system. Dual-Luciferase reporter gene assays, immunofluorescence, Western blot and qRT-PCR techniques were employed to assess the expression of key proteins and microRNAs. Comparable demographic and baseline clinical characteristics were observed between groups. The experimental group showed significantly improved pathological features, with an increase in PTEN-positive cells and upregulated protein expression of PTEN, mTOR, c-Met and IGF1R. Additionally, miRNA levels (miRNA-21, miRNA-122, miRNA-223, miRNA-199a and miRNA-375) were significantly reduced in the experimental group (p < 0.05), while mRNA levels for PTEN, mTOR, c-Met, YAP1 and IGF1R were significantly upregulated (p < 0.05). IOCS has a positive impact on liver tissue pathology in HCC patients by reducing apoptosis and modulating key molecular pathways. These findings suggest that IOCS could be a valuable therapeutic strategy for HCC, potentially guiding future treatment approaches and improving patient outcomes.