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Prognostic and Clinical Significance of Human Leukocyte Antigen Class I Expression in Breast Cancer: A Meta-Analysis

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Abstract

Background

The value of human leukocyte antigen (HLA; also known as major histocompatibility complex) class I expression for the prediction of breast cancer survival outcomes remains unclear. We conducted a meta-analysis to explore the prognostic significance of this expression.

Materials and Methods

We searched electronic databases to identify reports on associations of HLA class I protein or mRNA expression with survival outcomes and clinicopathological factors in the breast cancer context. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were used to conduct a quantitative meta-analysis.

Results

The sample comprised eight studies involving 3590 patients. Only the classical HLA class Ia (HLA-ABC) molecules studies were included in this meta-analysis. Elevated HLA class I protein expression was found to be significantly related to better disease-free survival (DFS) (HR 0.58, 95% CI 0.35–0.95, P = 0.03), particularly among patients with triple-negative breast cancer (TNBC) (HR 0.31, 95% CI 0.18–0.52, P < 0.001), but not to overall survival. It was also associated with estrogen receptor (ER) negativity (OR 1.71, 95% CI 1.24–2.35, P = 0.001), progesterone receptor (PR) negativity (OR 1.49, 95% CI 1.22–1.81, P < 0.001), human epidermal growth factor receptor 2 (HER2) positivity (OR 1.51, 95% CI 1.18–1.94, P = 0.001), TNBC (OR 1.68, 95% CI 1.15–2.45, P < 0.01), high Ki-67 indices (OR 2.06, 95% CI 1.62–2.61, P < 0.001), and high nuclear grades (OR 2.67, 95% CI 2.17–3.29, P < 0.001).

Conclusion

This meta-analysis demonstrated that enhanced HLA class I protein expression is significantly associated with the better DFS of patients with breast cancer, especially TNBC, as well as with ER and PR negativity, HER2 positivity, TNBC, and high Ki-67 indices and nuclear grades. The immune target HLA class I may serve as a prognostic indicator for breast cancer.

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Authors and Affiliations

  1. Department of Breast Surgery, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Jinghua Road No. 24, Luoyang, 471000, China

    Weiqiang Qiao, Wanying Guo, Qipeng Liu, Xiao Guo & Miao Deng

  2. Henan Provincial Key Medical Laboratory of Tissue Damage and Repair, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, China

    Zhiqiang Jia

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Correspondence to Miao Deng.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors, M.D., W.Q., Z.J., W.G., Q.L., and X.G. declare that there is no conflict of interest.

Author contributions

Miao Deng: conceptualization, methodology. Weiqiang Qiao: data curation, writing—original draft preparation. Zhiqiang Jia: visualization, investigation. Wanying Guo: supervision, software. Qipeng Liu: validation. Xiao Guo: writing—reviewing and editing.

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All data generated or analyzed during this study are included in this published article and supplementary information files, which are available from the corresponding author upon reasonable request.

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Qiao, W., Jia, Z., Guo, W. et al. Prognostic and Clinical Significance of Human Leukocyte Antigen Class I Expression in Breast Cancer: A Meta-Analysis. Mol Diagn Ther 27, 573–582 (2023). https://doi.org/10.1007/s40291-023-00664-z

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