Can the HLA phenotype be used as a prognostic factor in breast carcinomas?

There is evidence indicating that changes in the expression of HLA‐ABC antigens can modulate the biological behavior and metastatic potential of certain neoplasms. We studied 15 samples of normal breast epithelium, 94 breast carcinomas and 24 benign and pre‐malignant lesions of the mammary gland. All cases of normal breast epithelium and non‐malignant lesions presented high levels of expression of class‐1 antigens. In contrast, 22 out of 94 carcinomas showed a reduction in the level of expression and a heterogeneous pattern. In addition, 31 tumors were considered negative for HLA‐class‐I expression, and 6 cases showed selective loss of HLA‐ABC: 2 tumors for HLA locus A, and 4 for HLA locus B. We found a direct relationship between patient survival and HLA‐negative phenotype (p < 0.001), as well as between histological grade of malignancy and the level of expression of class‐l antigens (p < 0.0005). Moreover, the presence of class‐l molecules was significantly related to tumor ploidy (p < 0.005). Our results lead us to conclude that HLA‐ABC‐negative tumors have a higher metastatic potential and greater clinical aggressiveness: patients with carcinomas exhibiting low HLA expression have more lymph‐node metastases (p < 0.02) and achieve shorter survival times (p < 0.001).

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