Study On HLAA、 B Alleles And NPC Clinical Correlation And Prognosis Among The Chaoshanese

BackgroundNaspharyngeal carcinoma (NPC)，a malignant tumor occurred in thenas。pharyngeal epithelium，is the most common disease in the head and neck cancer．NPC is a rare malignancy throughout most of the world，but highly prevalence insouthern Chinese population．It displays obviOUS regional aggregation，familyaggregation and racial susceptibility．The etiology of NPC iS widely accepted thatit results from the joint effects of EBV，environments and genetiCS．The humanleukocyte antigen(HLA)system，encoding the major histocompatibility complex(MHC)in humans，plays an important role in NPC susceptibility．Up to now，several HLAalleles／hapl。types were reportedly associated with NPC among the southern Chinese，where HLA A02，B46，A02 B46 and A33 B58 are positively associated，and HLA A11，A31 and B27 are negatively associated．We previOUSly typed 247 NPC cases and274 controlS from the Chaoshan region for HLA A and B alleles．Besides confirmingthe established HLA NPC associations．the results also dem。nstrated a specific．recessive NPC disease susceptibility gene closely linked to the HLA region．However．the expression patterns of HLA A、B alleles and their clinical significance inNPC have yet to be determined．Based on our previous HLA NPC study，in thiS study，we explored further the correlation between HLA alleles and NPC clinicalcharacteristiCS，and assess the prognostiC value of them in NPC．PurposeThe study aimed to analyze the correlations between HLA A，B alleles and NPCclinicopathologiC characteristics．and assess the prognostiC value of them in NPCpatients． Mate r i al s and methodsSubjects and the HLA phenotypes in this study were from NPC patients in ourformer HLA NPC study，further，clinieal data were recollected．Finally，231 NPCpatients(174 males and 57 females)with age range from 14 to 76 years(average，47．7 years)involved in this study all the 231 NPC patients were restricted inChaoshanese．Correlations between the HLA A，B alleles and clinic。path。l。giccharacteristics were analyzed by logistic regression．Survival curves andestimations were carried out using the Kaplan Meier method，with the log rank testapplied to detect differences between groups．Univariate and multivariate survivalanalysis were performed using the Cox proportional hazards model．ResultsThe 5 year overall survival rate(OS)of all 231 NPC patients was 65．8％．theoverall survival rate was 59．7％to the last follow up time．Cox regression analysisdemonstrated that age(RR=I．027)，smoking(RR=I．781)，clinical stage(RR=2．558)，and T(RR=I．568)N(RR=2．578)M(RR=6．904)classification were significantprognostic factors for NPC 5 year OS．Cox proportional harzards regressionanalysis showed that，for patients at stage III～IV(n=167)，the HLA A24 was anegative prognostic factor(the hazard risk ratio is 1．825，95％CI=1．117 2．981，P=0．016)．Kaplan Meier survival analysis showed that the HLA A24 positive group(n=53)was a poorer prognosis than HLA A24 negative group(n=114)(cumulativesurvival rate were 47．2％and 65．8％respectively，Log rank P=0．029)．indicating thatHLA A24 was an independent prognostic factor for NPC patients at stage III～Ⅳ．When analysis was limited to stage I～II(n=64)，no HLA alleles were associatedwith clinical prognosis．Moreover，binary logistic regression suggested no HLA A or B allele wasassociated with NPC clinicopathologic feathers including histopathological type，clinical stage，lymph node status，and distant metastasis status．Ooncl usions Results indicate that HLA A24 was a negative prognostiC factor for stage III and IV NPC patients，and might serve as a potential biomarker for the prediction of the clinical outcomes in NPC．Age，smoking，clinical stage，and TNM classification were significantprognostic factors for NPC 5 year overall survival．No HLA f or B allele was associated with NPC clinic。path。l。gic feathers．...