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EPV285/#322 Human leukocyte antigen-g expression in vulvar squamous cell carcinoma
  1. N Boujelbene1,2,
  2. I Zemni2,3,
  3. W Babay2,
  4. H Ben Yahia2,
  5. S Dhouioui2,
  6. K Mrad1,
  7. HI Ouzari2,
  8. L Charfi1 and
  9. I Zidi2
  1. 1Salah Azaiez Institute of Cancerology, University of Tunis El Manar, Department of Pathology, Tunis, Tunisia
  2. 2University of Tunis El Manar,Sciences Faculty of Tunis, Laboratory of Microorganismes and Active Biomolecules, Tunis, Tunisia
  3. 3Salah Azaiez Institute of Cancerology, University of Tunis El Manar, Department of Surgical Oncology, Tunis, Tunisia


Objectives It is widely accepted that HLA-G belongs to the group of checkpoint molecules, implicated in different pathways of immune suppression allowing tumors escape. Here, we investigated HLA-G expression in vulvar squamous cell carcinoma (VSCC) to explore the potential implication of these molecules as prognostic markers.

Methods Immunohistochemistry was performed to evaluate HLA-G expression using the monoclonal antibody anti-HLA-G clone 4H84 that specifically identifies the denatured heavy chain of all HLA-G isoforms. Association with clinicopathological factors and survival were analyzed in 56 VSCC treated with radical vulvectomy. Mann-Whitney (MW) U test was used to estimate differences in HLAG levels expression in subgroups. Survival estimation was calculated by the Kaplan-Meier test.

Results HLA-G was highly expressed in 11 of the 56 (19.6%) primary tumor specimens. The high HLA-G expression level was reported in high-sized tumors (PMW=0.03) and increased invasion depth (PMW=0.01). HLA-G high expression was also noted in 72,7% of advanced stages with a borderline significance (PMW=0.08). A high level of HLA-G was not associated with tumors’ resection margins (PMW=0.18). Assessment of patients’ survival by Kaplan-Meier analysis indicated an adverse correlation between HLA-Ghigh expression and overall survival rate of VSCC patients (log-rank; P=0.000037). Therefore, the 5-year cumulative survival rates of patients with HLA-Ghigh expression was 10.5%. In the same way, HLA-G high expression reduced the disease-free survival (P=0.002).

Conclusions Our study shows that VSCC expresses high HLA-G that has been associated with an unfavorable clinical outcome. These findings suggest that HLA-G might be considered as a novel postoperative prognostic indicator for VSCC

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