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Human Leukocyte Antigen-DR Expression is Significantly Related to an Increased Disease-Free and Disease-Specific Survival in Patients With Cervical Adenocarcinoma
  1. Sanne Samuels, MD,
  2. Vivian M. Spaans, MD,
  3. Michelle Osse,
  4. Lex A.W. Peters, MD, PhD,
  5. Gemma G. Kenter, MD, PhD,
  6. Gertjan J. Fleuren, MD, PhD and
  7. Ekaterina S. Jordanova, PhD
  1. * Department of Gynaecology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Center Gynaecology Oncology Amsterdam (CGOA), Department of Gynaecology, Netherlands Cancer Institute, Amsterdam,
  2. Department of Gynaecology and Obstetrics, Leiden University Medical Center, Leiden, the Netherlands,
  3. Department of Pathology, Leiden University Medical Centre, Leiden, the Netherlands; and
  4. § Center Gynaecological Oncology Amsterdam (CGOA), Department of Obstetrics and Gynaecology, VU University Medical Centre, Amsterdam, the Netherlands.
  1. Address correspondence and reprint requests to Ekaterina S. Jordanova, PhD, Department of Obstetrics and Gynaecology, VU University Medical Centre, De Boelelaan 1118, 1081 HZ Amsterdam, the Netherlands. E-mail: e.jordanova{at}


Objectives Human leukocyte antigen (HLA) class II antigens are expressed on antigen-presenting cells, that is, macrophages, dendritic cells, and B lymphocytes. Under the influence of IFN-γ, HLA class II molecules can also be expressed on T lymphocytes, epithelial and endothelial cells. In addition, HLA class II antigens can be expressed in a variety of malignancies; however, the link with prognosis and ultimately patient survival is controversial.

Methods The pattern of HLA-DRA expression in cervical carcinoma was studied using immunohistochemistry. In total, 124 cervical carcinomas were examined, of which 60 (48.4%) were squamous cell carcinomas and 64 (51.6%) were adenocarcinomas.

Results In squamous cell carcinoma, HLA-DRA was expressed in 41 (68.3%) of 60 tumors, whereas in adenocarcinoma, HLA-DRA was expressed in 60 (93.8%) of 64 tumors (P < 0.001). In adenocarcinoma, HLA-DRA expression was associated with an increased disease-free survival (211.0 ± 13.0 vs 53.3 ± 30.5 months; P = 0.004) and disease-specific survival (226.45 ± 11.5 vs 75.8 ± 27.6 months; P = 0.002).

Conclusions Upregulation of HLA-DRA is significantly related to an increased disease-free and disease-specific survival in cervical adenocarcinoma. These data warrant further analysis of the functional role of HLA-DRA in these tumors.

  • Cervical cancer
  • Adenocarcinoma
  • HLA class II

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  • The authors declare no conflicts of interest.