Attia Mohamed A, Nosair Nahla A, Gawally Amro, Elnagar Gamal, Elshafey Eid M
Department of Clinical Pathology, Tanta University, Faculty of Medicine, Tanta, Egypt.
Acta Haematol. 2014;132(1):53-8. doi: 10.1159/000353757. Epub 2014 Feb 15.
The expression of human leukocyte antigen (HLA)-G was studied in certain malignancies and its role in escaping from immunosurveillance in cancers was proposed since HLA-G is a non-conventional HLA class I molecule that protects the fetus from immunorecognition during pregnancy. Some particles involved in the regulation of an immune system might represent prognostic value for B-cell chronic lymphocytic leukemia (B-CLL). The identification of novel prognostic factors in B-CLL may help define patient subgroups that may benefit from early therapeutic intervention.
To evaluate the prognostic significance of HLA-G expression in B-CLL patients and its relationship with other well-established prognostic markers.
Thirty B-CLL patients diagnosed by clinical, morphological and immunophenotyping criteria were studied for HLA-G expression by flow cytometry. The relationship between HLA-G expression and some known prognostic markers was evaluated.
HLA-G was expressed in 36.7% of CLL patients at diagnosis, with a mean expression level of 35.31 ± 12.35%. A significant association between HLA-G expression and common prognostic markers of progressive disease was detected. The group of patients with positive HLA-G expression showed significantly higher absolute lymphocyte counts and serum levels of LDH and β2-microglobulin, lower platelet counts, positive CD38 expression and advanced stages of Binet clinical staging.
The present study demonstrated that HLA-G expression correlates with prognostic markers of a poor B-CLL outcome, mainly Binet clinical staging and CD38 expression by B-CLL cells, which indicates that this parameter may play a role as an important prognosticator of disease progression and consequently targeted therapy in B-CLL.
人类白细胞抗原（HLA）-G在某些恶性肿瘤中的表达已被研究，且鉴于HLA-G是一种非常规的I类HLA分子，在孕期可保护胎儿免受免疫识别，故有人提出其在癌症免疫逃逸中的作用。一些参与免疫系统调节的因子可能对B细胞慢性淋巴细胞白血病（B-CLL）具有预后价值。鉴定B-CLL中的新预后因子可能有助于确定可能从早期治疗干预中获益的患者亚组。
评估HLA-G表达在B-CLL患者中的预后意义及其与其他已确立的预后标志物的关系。
对30例经临床、形态学和免疫表型标准诊断的B-CLL患者进行流式细胞术检测HLA-G表达。评估HLA-G表达与一些已知预后标志物之间的关系。
36.7%的CLL患者在诊断时表达HLA-G，平均表达水平为35.31±12.35%。检测到HLA-G表达与疾病进展的常见预后标志物之间存在显著关联。HLA-G表达阳性的患者组显示出明显更高的绝对淋巴细胞计数以及乳酸脱氢酶（LDH）和β2-微球蛋白的血清水平，更低的血小板计数，CD38表达阳性以及Binet临床分期处于晚期。
本研究表明，HLA-G表达与B-CLL不良预后的预后标志物相关，主要是B-CLL细胞的Binet临床分期和CD38表达，这表明该参数可能作为疾病进展以及B-CLL靶向治疗重要预后指标发挥作用。
