title: The role of host immune response and apoptosis in patients with laryngeal squamous cell carcinoma.
abstract: OBJECTIVE
  To determine whether the combined use of markers of host immune response (HLA-DR) and apoptosis (bax and bcl-2) can predict prognosis in laryngeal carcinoma patients.
  
  
  METHODS
  Immunohistochemical staining for HLA-DR, bax and bcl-2 proteins was investigated retrospectively in 37 patients with laryngeal squamous cell carcinoma. Seven healthy adult males were used as the control group.
  
  
  RESULTS
  HLA-DR antigen expression was detected in the tumor cells of 18 patients (48.6%). Another 18 patients (48.6%) expressed HLA-DR antigen in the peritumoral inflammatory infiltrate, while bax and bcl-2 protein expressions were detected in 17 (45.9%) and 9 (24.3%) patients, respectively. None of the controls expressed any of the proteins studied. bcl-2 and HLA-DR protein expressions of the tumor infiltrate were statistically significant independent prognostic factors suggesting improved survival (p = 0.0272 and p = 0.0285, respectively). bax+/bcl-2- patients demonstrated an unfavorable clinical outcome (p = 0.0298), followed by a significantly increased mean HLA-DR antigen expression observed both in the tumor and the stroma cells (p = 0.024 and p = 0.045, respectively).
  
  
  CONCLUSIONS
  bcl-2 and HLA-DR proteins independently predict a dismal prognosis among laryngeal carcinoma patients. The bax+/bcl-2- protein coexpression pattern correlates with elevated immunohistochemical expression of HLA-DR antigen both by tumor and peritumoral stromal cells.
  
  
  CONCLUSIONS
  bcl-2 and HLA-DR are significant prognostic markers in laryngeal carcinoma patients. Further prospective investigation is required to validate our findings.
authors.affiliation: Laboratory of Surgical Research, First Department of Propaedeutic Surgery, Hippokration Hospital, Athens Medical School, Athens, Greece. labsures@yahoo.com
authors.forename: I P
authors.initials: IP
authors.lastname: Gomatos
authors.forename: A
authors.initials: A
authors.lastname: Georgiou
authors.forename: J
authors.initials: J
authors.lastname: Giotakis
authors.forename: L
authors.initials: L
authors.lastname: Manolopoulos
authors.forename: K
authors.initials: K
authors.lastname: Apostolou
authors.forename: E
authors.initials: E
authors.lastname: Chatzigianni
authors.forename: K
authors.initials: K
authors.lastname: Albanopoulos
authors.forename: E
authors.initials: E
authors.lastname: Ferekidou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism; D000072224:Bcl-2-Like Protein 11; D015415:Biomarkers; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006684:HLA-DR Antigens / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D007822:Laryngeal Neoplasms / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism; D008875:Middle Aged; D011379:Prognosis; D011518:Proto-Oncogene Proteins / Q000378:metabolism; D012189:Retrospective Studies; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology; D051028:bcl-2-Associated X Protein / Q000378:metabolism
chemical_list: D051017:Apoptosis Regulatory Proteins; C000606775:BCL2L11 protein, human; D000072224:Bcl-2-Like Protein 11; D015415:Biomarkers; D006684:HLA-DR Antigens; D008565:Membrane Proteins; D011518:Proto-Oncogene Proteins; D051028:bcl-2-Associated X Protein