PRF1 and neoplasm: Further immunostaining experiments confirmed CD8+T-cell dysfunction with decreased levels of cytotoxic molecules (GZMB and PRF1) and increased the expression of immune checkpoints (PD-1 and PD L1) in the high-risk score group, resulting in a highly exhausted state and impaired immune function. The effect of tumor on immune cells can lead to T cell anergy or dysfunction, which promotes tumor escape and therapeutic drug resistance (55).