Vol 70, No 3 (2020)
Research paper (original)
Published online: 2020-06-16

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The prognostic significance of HLA-A2 expression on somatic cells in patients with left-sided colon and rectal cancers

Katarzyna Dyląg-Trojanowska1, Radosław Pach2, Maciej Siedlar3, Jarosław Baran3, Justyna Zybaczynska4, Antoni M. Szczepanik2
Nowotwory. Journal of Oncology 2020;70(3):92-97.


Introduction. Current knowledge about colorectal cancer (CRC) identifies tumor immunogenicity as one of the more important issues. In cancers, a prerequisite for immune system activation is the presentation of tumor associated antigen (TAA) epitopes to immunocompetent cells. HLA-A2 is one of the antigens in the context of which TAAs are present, but data on the possible impact of HLA-A2 antigen expression on the survival of patients with colorectal cancer are scarce and sometimes contradictory. The aim of this study was to analyse the relationship between HLA-A2 expression in patients with left-sided colorectal cancer in various stages of disease and their long-term survival, and to answer the question of whether a lack of HLA-A2 expression is actually a negative prognostic factor.

Material and methods.  A prospective analysis of 58 patients with left-sided colorectal cancer was carried out. Expression of HLA-A2 was determined by patient blood lymphocyte staining, and analysed using flow cytometry.

Results. In the study group, patients with HLA-A2 expression lived statistically longer than HLA-A2 negative patients (p = 0.027). There was no significant difference in overall survival between the HLA-A2+ and HLA-A2- groups with stage II and III left-sided CRC. However, the Cox proportional hazard model showed that a lack of HLA-A2 expression was a negative prognostic factor in the group of radically operated patients without distant metastases.

Conclusions. HLA-A2 status may affect the clinical course of patients with left-sided colon and rectal cancer, although left-sided tumors are less immunogenic than right-sided ones. HLA-A2-positive patients with left-sided colorectal cancer lived statistically longer than those who were HLA-A2-negative (p = 0.027). Lack of HLA-A2 expression was a negative prognostic factor in the group of radically operated patients.

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Nowotwory. Journal of Oncology