[HLA and thyroid cancer]

Association of HLA-B*51:01 with papillary thyroid carcinoma in the Chinese Han population of the Shandong coastal areas

BACKGROUND

A lot of work has been done to study the association between human leukocyte antigen (HLA) and papillary thyroid carcinoma (PTC) in various populations. But the results of the currently available studies are not consistent. The aim of this study was to evaluate the association of HLA-A, -B, -C, -DRB1, and -DQB1 with PTC in the Chinese Han population of the coastal areas of Shandong Province with respect to age and sex.

METHODS

A total of 154 patients diagnosed with PTC were analyzed for HLA-A, -B, -C, -DRB1, and -DQB1 alleles by using a polymerase chain reaction sequence-based typing (PCR-SBT) method. Two hundred unrelated healthy individuals were typed as controls.

RESULTS

Compared with the controls, the HLA-B*51:01 (8.8% vs. 4.5%, p=0.029, OR 2.039 [CI 1.101-3.775]) and HLA-C*07:06 (2.6% vs. 0.5%, p=0.024, OR 5.307 [CI 1.119-25.171]) allele frequencies were higher in the PTC patients, while the HLA-C*07:01 (1.3% vs. 6.0%, p=0.001, OR 0.206 [CI 0.071-0.601]) allele frequency was lower in the PTC patients that did not persist after Bonferroni correction for multiple tests. This showed no statistically significant correlation of the HLA-A, -DRB1, and -DQB1 alleles and PTC. The incidence of PTC was more frequent in females between 30 and 60 years old. There were no significant differences in the age and sex distributions between the total and the HLA-B*51:01 positive PTC patients.

CONCLUSIONS

The HLA associations in this Chinese Han population differ markedly from studies done in Europeans and Caucasians. The results reveal that HLA-B*51:01 is more likely to be a susceptible allele for PTC in addition to age and sex in the coastal areas of Shandong Province.

Association of HLA DQ4-DR8 haplotype with papillary thyroid carcinomas

OBJECTIVE

The association of the human leucocyte antigen (HLA) system with thyroid carcinomas is not clear. We sought to relate HLA alleles to susceptibility to papillary thyroid carcinoma (PTC) and also to clinical and pathological characteristics of PTC patients.

DESIGN AND PATIENTS

The distribution of HLA in 181 unrelated Caucasian patients with PTC was compared to the HLA distribution in 315 normal controls, 31 patients with follicular carcinoma (FTC), 29 patients with lymphocytic thyroiditis (LT) and 50 patients with multinodular goitre (MNG), using a microlymphocytotoxicity assay.

RESULTS

Compared to normal controls, patients with PTC showed a significantly increased frequency of HLA-DQ4 [12.8%vs. 3.5%, P=0.0005, P(corrected) (P(c))=0.0032, odds ratio (OR)=4.058, 95% confidence interval (95% CI)=1.820-9.045] and HLA-DR8 (10.9%vs. 4.3%, P=0.013, P(c) > 0.05, OR=2.752, 95% CI=1.275-5.940). DQ4 and DR8 were also significantly increased in patients with MNG (DQ4, 16.3%; DR8, 16.3%) compared to controls (DQ4, P=0.0019, P(c)=0.011, OR=5.420, 95% CI=1.978-14.852; DR8, P=0.0044, P(c)=0.062). Linkage disequilibrium (LD) for these two alleles was present in controls (D=0.0130, P=9.7e-57) and in MNG patients (D=0.0730, P=4.6e-19) but not in PTC patients (D=0.038, P>0.05). In the subgroup of PTC subjects with concomitant 0thyroidal neoplasias (n=27), there was a significant (P< 0.05) increase in the frequency of B57 (18.5%), DR11 (56.5%) and DQ3 (81.8%) compared to PTC patients without coexistent neoplasias (2.0%, 21% and 47%, respectively). No significant differences of HLA allele distribution was found in relation to PTC histology, age at diagnosis (> 45 or <or45 years), gender or tumour-node-metastasis (TNM) staging. In patients with FTC, the frequency of DR17 (FTC=51.6%; controls =; P=0.0009; P(c)=0.0138) was significantly increased compared to controls. Patients with LT showed a higher frequency of the DR11 allele (48.3%) than controls (DR11=21.3%; P=0.0028, P(c)=0.039, OR=3.445, 95% CI=1.568-7.567).

CONCLUSIONS

We have typed the largest series of patients with thyroid carcinomas reported to date, and found that DR8 and DQ4 are independent susceptibility markers for PTC.

Well differentiated thyroid carcinoma is associated with human lymphocyte antigen D-related 11 in Eastern Hungarians: a case of changing circumstances

BACKGROUND

Using serologic human lymphocyte antigen (HLA) typing, the authors previously described a strong association between well differentiated thyroid carcinoma and HLA D-related 1 (HLA-DR1) in a population of unselected patients from Eastern Hungary.

METHODS

In the current study, the authors used polymerase chain reaction-single strand conformational polymorphism to determine the HLA-DR type in 75 patients with well differentiated thyroid carcinoma from the same area as their previous population, and they compared the current results with the results from a group of 170 healthy controls.

RESULTS

A significant increase in HLA-DR11, rather than HLA-DR1, was observed in patients with well differentiated thyroid carcinoma among a population of patients from the same area that was studied previously. After excluding technical reasons to account for differences in disease association, they postulated that interim environmental factors, possibly radiation fall-out, may have resulted in differences in genetic susceptibility to thyroid carcinoma. Consideration of the potential antigenic peptides that may be restricted by the two HLA-DR alleles may have allowed for the binding of similar peptides to initiate an immune response, likely leading to progressive immunomodulation of the tumor. Discriminat function analysis indicated a significant relation between tumor size and metastases and less lymphocytic infiltration of the tumor, but this was not related to HLA-DR phenotypes.

CONCLUSIONS

The authors found that the study of major histocompatability complex alleles holds promise for understanding the events that initiate and maintain tumor immunomodulation.

Frequency of HLA-C alleles in differentiated thyroid carcinoma in southeastern Spain

BACKGROUND

The development of thyroid carcinoma may be influenced genetically and has been associated with certain HLA alleles. HLA-C alleles have not been studied in depth, because available serology techniques have not been very reliable in detecting them. However, the development of molecular biology provided an efficient and reliable technique for allele detection. The aims of the current study were to determine whether there is a significant association between any HLA-C allele and differentiated thyroid carcinoma and to establish the possible susceptibility or protection alleles related to these tumors.

METHODS

HLA-C genotyping was performed in 63 patients undergoing surgery for differentiated thyroid carcinoma (57 patients with the papillary subtype and 6 patients with the follicular subtype). A representative sample of 100 nonrelated healthy Caucasians was used as a control group from the same geographic area. The polymerase chain reaction-sequence-specific primer technique was used for HLA-C genotyping. The clinical variables analyzed were age, gender, family history of thyroid pathology, residence in areas of endemic goiter, asymptomatic status, presence of hyperthyroidism, compressive symptoms, presence of an intrathoracic thyroid component, histologic variables of the tumor, and evolution. The chi-square test, the Mantel-Haenszel test, and the Bonferroni correction were used for the statistical analysis.

RESULTS

In the control group, a significant correlation was observed between the lower frequency of the HLA-Cw7 allele and the development of differentiated thyroid carcinoma (P < 0.05). Analysis of the different clinical variables revealed a relation between HLA-C alleles and three clinical situations: cervical lymph node involvement with HLA-Cw7 and HLA-Cw2, vascular involvement with HLA-Cw7 and HLA-Cw1, and cervical carcinoma recurrence with HLA-Cw1. However, after application of the Bonferroni correction, only the association between HLA-Cw7 and lymphatic (P(c) = 0.0483) or vascular involvement (P(c) = 0.0324) persisted.

CONCLUSIONS

The results revealed a relation between HLA-Cw7 and differentiated thyroid carcinoma. In future investigations, HLA-C typing may help to identify patients with a poor prognosis.

A report of six cases of familial papillary thyroid cancer

AIMS

Familial occurrence of papillary thyroid cancer is uncommon. The purpose of this study was review our own experience in a series of 267 papillary thyroid cancers.

METHODS

We analysed the clinical records of 267 consecutive patients operated on for papillary thyroid cancer (PTC) in our hospital between June 1980-March 2000.

RESULTS

We identified a family history in three families (6 patients), which results in a 2.25% familial papillary thyroid carcinoma (FPTC) rate. Pathology findings revealed that the tumour was multifocal and bilateral in 2 patients. Lymph-node metastases were found in 4 patients. They are all alive with a mean time of follow-up of 74.3 months (range 2-120).

CONCLUSIONS

We recommend that patients with familial disease should be treated according to the disease stage and other risk factors, similar to those with sporadic differentiated papillary thyroid cancer. We encourage the further reporting and pedigree analysis to identify patients affected by FPTC.

The immunology of thyroid cancer

This article reviews the immunologic aspects of thyroid cancer, including thyroid-specific effector elements on thyroid cancer, and discusses the potential antigens, unique molecular markers, and transcription factors that could serve as targets for immunotherapy. The potential role of this type of treatment for thyroid cancer is examined also.

Family with nonmedullary thyroid neoplasms

This report concerns a family in which papillary thyroid carcinoma appeared in the father and two daughters and follicular adenoma in a granddaughter. The father died of systemic metastasis of papillary thyroid carcinoma. The two daughters and granddaughter felt well postoperatively. We speculate that some gene-related factors might play an important role in familial occurrence of papillary thyroid carcinoma and follicular thyroid adenoma in the family.

Both class I and class II HLA antigens are thyroid cancer susceptibility factors

It has been established that HLA antigens are susceptibility factors for different cancers, including thyroid tumors. However, the diversity and sometimes weak and contradictory associations found have frequently led to the view that the HLA and tumorigenesis links might be the result of statistical errors. However, it has recently been established that it is indeed a currently complex and unexplained but real phenomenon, which may be crucial in preventing several types of cancer. In the present work we have found in a relatively large series of thyroid cancer patients (n = 161) that both HLA class I (B35) and class II (DR11) antigens are susceptibility factors only in the papillary tumor group of patients, B35 association p value is found at the limit of significance (pc(120) = 0.05); the follicular group did not show any HLA association, suggesting that the etiopathogenesis of each type of cancer is different. HLA-B35 and DR11 are not working together to induce tumorigenesis and each of them seems to confer susceptibility by using different pathways or by being markers of distinct neighboring susceptibility genes. DR4 has also been found in 86% (n = 6) of Hürthle cell carcinoma. No association has been found between HLA and disease activity. HLA mechanisms of association to cancer are discussed and a world-wide HLA/tumorigenic study is proposed to obtain a clear picture of the puzzling and controversial susceptibility markers found in different tumors and in different ethnic groups.

Risk factors for bilateral testicular germ cell tumors. Does heredity play a role?

Twenty-three bilateral testicular germ cell tumors (four synchronous and 19 sequential tumors) were investigated for potential risk factors. The incidence of maldescensus testis was not found to be higher than in patients with unilateral disease. The histologic findings of the first tumor did not have any effect on the incidence of the second tumor. In 21 patients (four synchronous and 17 sequential tumors), histocompatibility antigens (HLA) were determined; HLA-B14 was increased significantly in the sequential tumor group. Tendencies toward an increase of HLA-DR5 and HLA-DR7 also were found. The HLA-DR1, HLA-DR3, and HLA-DR4 showed a tendency toward a decreased frequency. Therefore genetic factors might be important in the development of sequential bilateral testicular cancers.

HLA-antigen distribution in seminoma, HCG-positive seminoma and non-seminomatous tumours of the testis

Histocompatibility antigens play a certain role in the development of testicular tumours. 151 patients with testicular cancer (86 non-seminomatous germ cell tumours--NSGCT--and 65 pure seminoma) were typed for the HLA-antigens of the A, B, C and DR locus. 24 patients of the pure seminoma group and 50 patients of the NSGCT group had an elevated serum HCG level preoperatively. The antigen DR-5 was elevated in the seminoma group whereas the incidence of B-13 was increased in the NSGCT group. In terms of antigen distribution HCG-positive seminoma resembles seminomatous tumours rather than NSGCT.

HLA-DR and differentiated thyroid cancer. Lack of association with the nonmedullary types and possible association with the medullary type

One hundred twenty-seven white European patients with differentiated thyroid cancer were typed for human lymphocyte antigen (HLA) DR specificities. There was no significant deviation from the HLA-DR distribution observed in 160 normal patient controls, neither in the entire group nor in the patient groups with nonmedullary types of thyroid cancer (61 with papillary and 44 with follicular, all nonradiation associated). Also, subdivision of patients with nonmedullary thyroid cancer according to age at diagnosis, presence of metastases, and presence of thyroglobulin antibodies in serum showed no significant deviation from the HLA-DR distribution. For the patients with medullary thyroid cancer (only sporadic [n = 20] or inherited isolated [n = 2] forms, no multiple endocrine neoplasias), there was a significant increase of HLA-DR2 (11 of 22 cases [50%]) in comparison with control patients (22%; P corrected to 0.02; relative risk, 3.6). These data suggest, in contrast to previous reports, that there is no genetic influence on the development of nonmedullary types of differentiated thyroid cancer. Medullary thyroid cancer without multiple endocrine neoplasia, however, may be associated with HLA-DR2.