CTLA4 and hepatocellular carcinoma: Overexpression of immune check point molecules programmed death 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) in HCC has been associated with higher recurrence rates, more aggressive disease, and poorer clinical prognosis (50, 51).