Transcriptomic analyses further highlighted this disparity between different etiologies, revealing elevated expression levels of FOXP3 and genes linked to the IL-10 signaling pathway, as well as exhaustion marker genes like PD-1 and CTLA4, in viral HCC, indicating a potentially more immunosuppressive or exhausted microenvironment [51]. This evidence concerns the gene PDCD1 and hepatocellular carcinoma.