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HLA-G expression in gastric carcinoma: clinicopathological correlations and prognostic impact

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Abstract

To analyze expression of human leukocyte antigen-G (HLA-G) in gastric adenocarcinoma and correlate its expression with histological and clinical variables. A continuous series of 94 unselected patients with gastric adenocarcinoma (stage I to III) were selected. All histological and clinical variables were collected including the intensity of intra- and peri-tumor lymphocytic infiltration. HLA-G expression was investigated using immunohistochemistry. All histological samples analyzed for HLA-G expression were taken from the primary gastric lesion and included non-neoplastic mucosa. Evaluation of HLA-G expression was performed on the transition zone between tumor and non-neoplastic mucosa, and the invasive front of the tumor and assessment was performed as follows: percentage of positive (strong expression vs weak) cells. A variable amount of HLA-G-positive tumor cells was found in 24 out of 94 cases (25.5%). No significant correlation was found between HLA-G expression and other clinicopathological variables (sex, age, stage, grade, histotype). The overall median survival was worse in patients with HLA-G-positive adenocarcinoma (24.3 months, CI95% 7.7–41.0) compared to those with HLA-G-negative tumors (66.3 months, CI95% 53.0–79.7; p < 0.0001). Two- and 5-year survival rates of HLA-G-negative patients were 88 and 44%, respectively, while were 42 and 11% in those HLA-G-positive. This trend was observed in all stages but was more marked in stage III. HLA-G expression is associated with poor survival in stage III gastric cancer patients and represents a possible immunoescape mechanism of cancer cells.

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Authors and Affiliations

  1. Clinical Immunology Unit, Department of Internal Medicine (DIMI), University of Genoa and Ospedale Policlinico San Martino, Viale Benedetto XV, n. 6, 16132, Genoa, Italy

    Giuseppe Murdaca, Ottavia Magnani & Francesco Puppo

  2. Anatomic Pathology Unit, Department of Surgical and Diagnostic Sciences, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy

    Paola Calamaro, Simona Pigozzi, Luca Mastracci, Federica Grillo, Paola Ceppa & Roberto Fiocca

  3. Department of Health Sciences, Biostatistics Unit, University of Genoa, Genoa, Italy

    Francesca Lantieri

Authors
  1. Giuseppe Murdaca
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  2. Paola Calamaro
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  3. Francesca Lantieri
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  4. Simona Pigozzi
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  9. Francesco Puppo
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Correspondence to Giuseppe Murdaca.

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Human rights statement and informed consent

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. This analysis was approved by the Ethics Committees at the Ospedale Policlinico San Martino.

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Guidelines of the STROBE statement have been adopted.

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Murdaca, G., Calamaro, P., Lantieri, F. et al. HLA-G expression in gastric carcinoma: clinicopathological correlations and prognostic impact. Virchows Arch 473, 425–433 (2018). https://doi.org/10.1007/s00428-018-2379-0

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  • DOI: https://doi.org/10.1007/s00428-018-2379-0

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