Abstract
One hundred large bowel carcinomas operated on between 1978 and 1982 were studied immunohistochemically with regard to expression of HLA-DR antigens. Three sections from each tumour were investigated by a semiquantitative scoring system, and a mean score for each patient established. Based on this scoring system, the tumours were divided into three groups: 0; 0.1-1.0; and > 1.0. All patients were followed until death (n = 68) or until June 1, 1992, and all cancer-specific deaths (n = 56) have been recorded. Analysis of survival in the whole patient group showed significant difference between the three levels of tumour HLA-DR expression (P = 0.006); patients who had tumours with strong HLA-DR expression showing the best survival. In a stratified analysis after Dukes' stages there was still a significant difference (P > 0.001) between the three levels of HLA-DR staining intensity. After a multiple regression analysis (Cox) with correction for different variables, the HLA-DR expression maintained its significance as a risk factor. To our knowledge this is the first time a relationship between intensity of tumour DR expression and survival has been shown in large bowel carcinoma.
Highlights
When omitting the primary antibody or replacing it with an antibody of the same isotype (IgG2a), no staining was seen in adjacent sections from a tumour which stained positive with the anti-HLA-DR antibody
There were no significant differences in HLA-DR score between tumours in each Dukes' stage (Table II), whereas there were slightly more DR-positive tumours in the poorly differentiated group, compared to the better differentiated tumours (P = 0.04), (Table III)
The main finding of the present paper was the significant relationship between the HLA-DR expression of the tumour cells and survival of the patients
Summary
The purpose of the present study was to test a possible prognostic significance of tumour DR-expression in 100 large bowel carcinomas with at least 10 years postoperative observation time
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