Abstract
An increased peripheral soluble HLA-G (sHLA-G) expression has been observed in various malignancies while its prognostic significance was rather limited. In this study, the prognostic value of plasma sHLA-G in 178 colorectal cancer (CRC) patients was investigated. sHLA-G levels were analyzed by specific enzyme-linked immunosorbent assay. Data showed sHLA-G levels were significantly increased in CRC patients compared with normal controls (36.8 U/ml vs 25.4 U/ml, p = 0.009). sHLA-G in the died were obviously higher than that of alive CRC patients (46.8 U/ml vs 27.4 U/ml, p = 0.012). Patients with sHLA-G above median levels (≥ 36.8 U/ml, sHLA-Ghigh) had a significantly shorter survival time than those with sHLA-Glow (< 36.8 U/ml, p < 0.001), and sHLA-G could be an independent prognostic factor for CRC patients. With stratification of clinical parameters in survival by sHLA-Glow and sHLA-Ghigh, sHLA-G exhibited a significant predictive value for CRC patients of the female (p = 0.036), the elder (p = 0.009), advanced tumor burden (T3 + 4, p = 0.038), regional lymph node status (N0, p = 0.041), both metastasis status (M0, p = 0.014) and (M1, p=0.018), and clinical stage (I + II, p = 0.018), respectively. Summary, our data demonstrated for the first time that sHLA-G levels is an independent prognosis factor and improves the prognostic stratification offered by traditional prognosticators in CRC patients.
Highlights
In China, colorectal cancer (CRC) incidence and mortality have been increasing during the last decade, resulting in an estimated 376,300 new cases and 191,000 deaths in 2015 [1]
Our data demonstrated for the first time that soluble HLA-G (sHLA-G) levels is an independent prognosis factor and improves the prognostic stratification offered by traditional prognosticators in CRC patients
Plasma sHLA-G related to survival in CRC patients
Summary
In China, CRC incidence and mortality have been increasing during the last decade, resulting in an estimated 376,300 new cases and 191,000 deaths in 2015 [1]. The immune system has proven to play critical roles in tumorigenesis Various strategies such as induction of regulatory cells, alteration of antigen presentation and production of immune suppressive mediators, have been developed by tumor cells to have a successful immune evasion [2]. For the importance of the host immune system involved in tumor progression, previous literatures have demonstrated the impact of immune-classification (termed Immunoscore), and its prognostic value has been demonstrated superior to the classical TNM classification for CRC [3,4,5]. Previous studies revealed that both membrane-bound and sHLA-G isoforms could render multiple immune suppressive effects during the progression of malignancies, with involved mechanisms by inhibiting immune cell function, inducing apoptosis and the generation of regulatory cells through receptor binding and/or trogocytosis, and impairing chemotaxis of different immune effector cells [7, 8]
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