title: HLA class I expression and its alteration by preoperative hyperthermo-chemoradiotherapy in patients with rectal cancer.
abstract: OBJECTIVE
  Enhancing immunologic responses, including human leukocyte antigen (HLA) class I expression on tumor cells and recognition and elimination of tumor cells by tumor-specific cytotoxic T lymphocyte (CTL), is considered a novel concept of radiotherapy. The present study examined patients who underwent preoperative hyperthermo-chemoradiotherapy (HCRT) for locally advanced rectal cancer to assess the correlation between HLA class I expression and clinical outcome.
  
  
  METHODS
  Seventy-eight patients with locally advanced rectal adenocarcinoma who received preoperative HCRT were enrolled. The median age of the patients was 64 years (range, 33-85 years) and 4, 18, and 56 patients had clinical stage I, II and III disease, respectively. Formalin-fixed and paraffin-embedded tissues excised before and after HCRT were subjected to immunohistochemical analysis with an anti-HLA class I-A, B, C antibody. HLA class I expression was graded according to tumor cell positivity.
  
  
  RESULTS
  In pre-HCRT, the number of specimens categorized as Grade 0 and 1 were 19 (24%) and 58 (74%), respectively. Only 1 patient (1%) showed Grade 2 expression. However, 6 (8%), 27 (35%), 7 (9%), and 12 (15%) post-HCRT specimens were graded as Grade 0, 1, 2, and 3, respectively. There was a significant increase in HLA class I expression in post-HCRT specimens (p<0.01). However, neither pre- nor post-HCRT HLA class I expression affected overall survival and distant metastasis-free survival in clinical stage III patients. Univariate analysis revealed that Post-HCRT HLA class I expression showed a significant negative relationship with LC (p<0.05). Nevertheless, multivariate analysis showed that there was no correlation between HLA class I expression and clinical outcome.
  
  
  CONCLUSIONS
  HCRT increased HLA class I expression in rectal cancer patients. However, multivariate analysis failed to show any correlation between the level of HLA class I expression and prognosis.
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Hiro
authors.initials: H
authors.lastname: Sato
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Ide
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Katoh
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Shin-Ei
authors.initials: SE
authors.lastname: Noda
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oike
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Yoshimoto
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Okonogi
authors.affiliation: Department of Surgery, National University of Singapore, Singapore, Singapore.
authors.forename: Kousaku
authors.initials: K
authors.lastname: Mimura
authors.affiliation: Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D015870:Gene Expression; D015395:Histocompatibility Antigens Class I / Q000235:genetics / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D006979:Hyperthermia, Induced; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D015395:Histocompatibility Antigens Class I