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卵巢漿液性癌患者HLA-G的表達與預後
Expression and prognosis of human leukocyte antigen G in ovarian serous carcinoma
摘要
目的：探討人類白細胞抗原G（human leukocyte antigen, HLA-G）在卵巢漿液性癌（serous ovarian carcinoma, SOC）組織中的表達與患者預後的關係。方法：回顧性分析SOC患者臨床及病理資料，免疫組化法檢測SOC組織中HLA-G表達情況，並分析其與臨床病理特徵及預後的關係。結果：HLA-G蛋白陽性率在SOC癌組織（77.08%）中顯著高於癌旁組織（6.25%）。94.44%的HLA-G低表達組卵巢癌患者臨床病理分期是III-IV期，與HLA-G高表達組患者臨床病理分期比較，有統計學差異。HLA-G低表達組平均生存時間62.77±7.82月，HLA-G高表達組平均生存時間92.13±15.2月。Kaplan-Meier生存分析顯示HLA-G高表達組5年的生存率為75%，高於HLA-G低表達組的5年生存率52%，但無統計學差異。Cox回歸分析顯示，化療耐藥（HR=10.700, 95%CI=3.433～33.349, P=0.000）是SOC患者不良預後的預測因子，而HLA-G高表達（HR=0.132, 95%CI=0.035～1.098, P=0.045）是保護性因素。結論：與正常組織相比HLA-G在SOC中表達較高。HLA-G在晚期SOC組織中比早期者表達量低，但其表達量與病理分級無關。HLA-G低表達的SOC患者預後更差，這可能與化療耐藥有關。
並列摘要
Objective: To investigate the relationship between human leukocyte antigen (HLA)-G expression and prognosis in serous ovarian carcinoma (SOC) patients. Methods: The clinical and pathological data of SOC patients were retrospectively analyzed, and the expression of HLA-G in SOC tissues was detected by immunohistochemistry, and its relationship with clinicopathological features and prognosis was analyzed. Results: HLA-G was positive in 77.08% (37/48) SOC tissues. In 94.44% HLA-G low-expression group, the clinicopathologic stage was advanced stage (III-IV), which was significantly different from that in the high-expression group. However, there was no difference in pathological grade between the two groups. The average survival time of patients in the low-HLA-G expression group was 62.77±7.82 months, and that of patients in the high HLA-G expression group was 92.13±15.2 months. The Kaplan-Meier survival analysis revealed that the 5-year survival rate of the high-HLA-G expression group was 75%, which was higher than that of the low-expression HLA-G group of 52%, but the difference was not statistically significant. Cox regression analysis revealed that chemotherapy resistance was a predictor of adverse OS in SOC patients (HR=10.700, 95%CI=3.433~33.349, P=0.000), whereas high expression of HLA-G was a protective factor (HR=0.132, 95%CI=0.035~1.098, P=0.045). Conclusion: HLA-G is highly expressed in SOC compared with normal tissues. The expression of HLA-G was low in advanced (stage III-IV) SOC patients, but was not related to the pathological grade. The SOC patients with low HLA-G expression have a worse prognosis, which may be related to chemotherapy resistance.