PDCD1 and neoplasm: HCC is a highly heterogeneous and aggressive malignancy.[18, 19, 20] Its complex TME significantly affects immunotherapy efficacy.[21, 22, 23] Although PIVKA‐II is a clinically approved diagnostic biomarker for HCC diagnosis,[24, 25] its role in tumor aggressiveness, prognosis, and response to anti‐PD‐1 plus lenvatinib therapy remains underexplored.