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. 2009 Oct 20;101(8):1321-8.
doi: 10.1038/sj.bjc.6605315. Epub 2009 Sep 15.

Human leukocyte antigen class I expression is an independent prognostic factor in advanced ovarian cancer resistant to first-line platinum chemotherapy

M Shehata  1 , A Mukherjee, S Deen, A Al-Attar, L G Durrant, S Chan
Affiliations

Human leukocyte antigen class I expression is an independent prognostic factor in advanced ovarian cancer resistant to first-line platinum chemotherapy

M Shehata et al. Br J Cancer. .

Abstract

Background: Loss of HLA class I is important in ovarian cancer prognosis but its role as a prognostic indicator in relation to therapy remains unproven. We studied the prognostic potential of this antigen and its significance in relation to platinum therapy.

Methods: A total of 157 primary ovarian cancers were assessed for HLA class I immunohistochemically and linked to a comprehensive database of clinicopathological variables, treatment details, and platinum sensitivity.

Results: Tumours expressing high levels of HLA class I had significantly improved survival (P=0.044). There was a 19-month difference in the median overall survival between tumours with high and low antigen expression. HLA class I antigen expression, stage, and platinum sensitivity were independently predictive of prognosis on multivariate analysis. HLA class I antigen was shown to be expressed at higher levels in patients with good overall survival in platinum-resistant patients (P=0.042). HLA class I significantly correlated with overall survival on multivariate analyses (P=0.034).

Conclusion: Low-level HLA class I expression is an independent prognostic indicator of poor clinical outcome in ovarian cancer. The survival advantage of patients with platinum-resistant tumours expressing high levels of HLA class I suggests that immunotherapy may be of use in these ovarian cancers resistant to standard chemotherapy.

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Figures

Figure 1
Figure 1
Immunohistochemical staining of tissue microarray cores with β2m and hC10 antibodies. (A and B) Cores from tumour showing negative (A) and positive (B) β2m staining. (C and D) Cores of tumour showing negative (C) and positive (D) hC10 staining. Original magnification × 100; insets × 400.
Figure 2
Figure 2
Association of HLA-I expression with overall survival time in 154 patients with primary ovarian cancer. Median survival time was 37 months for patients with negative HLA-I expression (HLA-I negative, n=72) compared with 56 months for patients with positive HLA-I expression (HLA class I positive, n=82). The difference was significant in the log-rank test (P=0.0448).
Figure 3
Figure 3
Association of HLA class I expression with overall survival time in patients with primary ovarian cancer stratified according to their platinum sensitivity. (A) The Kaplan–Meier survival graph in platinum-sensitive and (B) platinum-resistant patients. The difference in survival was only significant in the platinum-resistant group; log-rank test (P=0.0419).
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