Down-regulation of HLA class I antigen is an independent prognostic factor for clear cell renal cell carcinoma
Down-regulation of HLA class I antigen is an independent prognostic factor for clear cell renal cell carcinoma
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DOI：
10.1016/j.juro.2006.11.082
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发表时间：
2007-04-01
影响因子：
6.6
通讯作者：
Tsukamoto, Taiji
中科院分区：
文献类型：
--
作者：
Kitamura, Hiroshi;Honma, Ichiya;Tsukamoto, Taiji
目的：我们确定 I 类人类白细胞抗原对透明细胞肾细胞癌患者生存的预后影响。材料和方法：对 45 名透明细胞肾细胞癌患者的标本进行 HLA I 类免疫组织化学染色。我们对影响病因特异性生存的各种因素进行了单变量和多变量分析，包括 HLA I 类、Fuhrman 分级、TNM 分期和肿瘤大小。此外，我们使用 Kaplan-Meier 方法和对数秩检验比较了 HLA I 类阳性肾细胞癌患者与 HLA I 类下调患者的生存率。结果：在 17 例 (37.8%) 透明细胞肾细胞癌中，HLA I 类免疫组织化学下调。下调与其他临床病理参数如肿瘤大小、肾周脂肪浸润、肿瘤血栓、TNM分期或核分级没有相关性。单因素和多因素分析显示HLA I类表达、肿瘤分级和TNM分期是影响肾细胞癌患者疾病特异性生存的重要因素。在5年随访中，HLA I类阳性肾细胞癌患者的无复发生存期比表达下调的患者更长（分别为95.5%和61.1%）。 结论：我们的数据表明肿瘤细胞上HLA I类的下调是透明细胞肾细胞癌的独立预后因素。这一发现表明HLA I 类限制性细胞毒性T 淋巴细胞在抑制肾细胞癌中具有重要作用。
Purpose: We determined the prognostic impact of human leukocyte antigen class I on the survival of patients with clear cell renal cell carcinoma.Materials and Methods: Immunohistochemical staining for HLA class I was performed on specimens from 45 patients with clear cell renal cell carcinoma. We performed univariate and multivariate analyses of various factors affecting cause specific survival including HLA class I, Fuhrman grade, TNM stage and tumor size. Furthermore, we compared the survival of patients with HLA class I positive renal cell carcinoma to that of those with down-regulated HLA class I using the Kaplan-Meier method and log rank test.Results: HLA class I was immunohistochemically down-regulated in 17 (37.8%) clear cell renal cell carcinomas. The down-regulation had no correlation with other clinicopathological parameters such as tumor size, perirenal fat invasion, tumor thrombus, TNM stage or nuclear grade. Univariate and multivariate analyses revealed that HLA class I expression, tumor grade and TNM stage were significant factors influencing the disease specific survival of patients with renal cell carcinoma. Patients with HLA class I positive renal cell carcinoma had longer recurrence-free survival than those with down-regulated expression at 5-year followup (95.5% and 61.1%, respectively).Conclusions: Our data demonstrate that down-regulation of HLA class I on tumor cells is an independent prognostic factor for clear cell renal cell carcinoma. This finding suggests that HLA class I restricted cytotoxic T lymphocytes have an important role in the suppression of renal cell carcinoma.