HLA-DR4 ANTIGEN AND LYMPH-NODE METASTASES IN POORLY DIFFERENTIATED ADENOCARCINOMA OF THE STOMACH

Background. The authors investigated whether HLA antigens could act as a predictor of the risk of lymph node metastasis in patients with gas tric cancer. Methods. The microcytotoxicity assay was used to examine 51 HLA antigens of the A, B, C, DR, and DQ loci in 573 patients who un derwent resection of gastric cancer. The incidence of HLA antigens in patients with or without lymph node metastasis was analyzed using the chi-square method. Results. The incidence of patients with HLA-DR4 ant igen with or without lymph node metastasis was 45.9% and 34.8%, respec tively (P = 0.0098, corrected P = 0.49). The relative risk of lymph no de metastasis in patients with HLA-DR4 was 1.6. In poorly differentiat ed adenocarcinoma, the incidence of HLA-DR4 antigen in patients with l ymph node metastasis was significantly higher (47.5%) than in patients without lymph node metastasis (18.5%), if corrected P values were tes ted (P = 0.0007, corrected P = 0.0387). The relative risk of lymph nod e metastasis in patients with poorly differentiated adenocarcinoma wit h DR4 was 4.0. Conclusions. The data suggest an association between th e presence of HLA-DR4 and an increased risk of lymph node metastasis, especially in poorly differentiated adenocarcinoma.