An evaluation of the prognostic significance of HLA-DR expression in axillary-node-negative breast cancer.
BACKGROUND
Adjuvant treatment for node-negative breast cancer remains controversial. It is important to pick out the high-risk groups who may benefit from adjuvant systemic therapy and avoid the unnecessary additional therapy for the favorable prognostic groups.


METHODS
Retrospective study of immunohistochemical staining for HLA-DR on tumor cells from paraffin-embedded tissue specimens of 32 patients with node-negative invasive breast cancer at this hospital from 1986 to 1991 was performed with the aim to investigate its prognostic significance.


RESULTS
HLA-DR staining was positive in nine (28%) patients and negative in twenty-three (72%) patients. One (11%) was a recurrence, and no (0%) death occurred in the positive group, compared with nine (39%) recurrences and five (22%) deaths in the negative group. The multivariate analysis failed to show that HLA-DR expression is an independent prognostic factor. However, with univariate analysis, the 5-year disease-free survival rate (87%) of the positive group was significantly better than that (35%) of the negative group (p = 0.04). The 5-year overall survival rate (100%) of the positive group was also better than that (66%) of the negative group, but the difference was not statistically significant. Furthermore, when combination of the HLA-DR expression and estrogen receptor status was used, both the 5-year disease-free and overall survival rate (81% and 100%, respectively) of group A (positive staining for either HLA-DR or estrogen receptor and positive staining for both) were significantly better than those (33% and 58%, respectively) of group B (negative staining for both HLA-DR and estrogen receptor).


CONCLUSIONS
We believe HLA-DR expression may be a promising, additive predictive factor to node-negative breast cancer and deserves further investigation based on these preliminary results.
Sheen-Chen
S M
SM
Department of Surgery and Pathology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China.
Chou
F F
FF
Eng
H L
HL
Chen
W J
WJ
D000328:Adult; D000368:Aged; D001365:Axilla / Q000473:pathology; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D005260:Female; D006684:HLA-DR Antigens / Q000032:analysis*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis; D012189:Retrospective Studies; D015996:Survival Rate
D006684:HLA-DR Antigens; D011960:Receptors, Estrogen