ÜRO-ONKOLOJİ DEĞİŞİCİ EPİTEL HÜCRELİ MESANE KANSERİ OLGULARINDA HLA TİPLEMESİ TYPES OF HLA IN THE PATIENTS WITH TRANSITIONAL CELL CARCINOMA OF BLADDER Ali Uğur ÖZALP, Arman ÇEKMEN, Bülent ÖNAL, Zübeyr TALAT, Burak ÖZKAN, Vural SOLOK İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Üroloji Anabilim Dalı, İSTANBUL ABSTRACT Introduction: Human Leucocyte Antigenes (HLA) may play a complementary role in the interaction between tumor and body immunology. In this study, HLA antigens of patients with transitional cell carcinoma (TCC) of the bladder were compared with HLA antigens of the control group and the association between the HLA system and TCC were investigated. Materials and Methods: By using the standard microlymphocytotoxicity method of Terasaki in our study, the HLA A, B, DR and DQ antigen types of 30 patients with TCC of the bladder, were compared with the control group of 30 healthy people who was a donor for kidney transplantation. Histological stage and grade of bladder tumors were established according to the International Union Against Cancer classification. Odds ratio (OR), Fischer’s exact test and Chi square tests were used for statistical analysis. Results: the mean age was 64.3±10.8 years in the patients with TCC. Histopathological stage was pTa, pT1 (superficial) in 13 patients (43.3%) and pT2, pT3 and pT4 (invasive) in 17 patients (56.7%). A total of 9 patients (30%) low grade and 21 high grade TCC (70%). Carcinoma in situ (CIS) of bladder was determined in 18 patients (60%). HLA-A 10, HLA-B 4, HLA-DR 53 and HLA-DQ 1 antigens were detected significantly higher in the control group compared to the patient group and there was statistically significant (p<0.05). HLA-A 25 (10) was positive in 4 patients with TCC but no observed in the control group. No statistically significant was found (p=0.112), (OR 2.15, 95% confidence interval 1.62 to 2.85) HLA-DQ 6 (1) was detected in 60% and 26.7% of the patients in TCC and the control group, respectively, (p=0.018), (OR 4.12). Similarly, HLA-DQ 7 (3) was found in 63.3% and 33.3% of the patients in TCC and the control group, respectively, (p=0.038), (OR 3.45). In addition HLA-B 51 (5) in patients with low grade was found significantly higher (p=0.02). when the patients with CIS were evaluated only HLA-B 4 was found differently. Conclusion: The results revealed that the people, carrying the antigens that were detected in the patient group, were highly at the risk of TCC and the antigens that were highly detected in the control group, could be accepted as protective for TCC. In the future further researches to be performed in our population will be more illuminating to confirm these results. We have thought that sampling of HLA profiles may be useful for evaluating the people at risk of TCC besides for planning their prognosis and the treatment. Key Words: Transitional Cell Carcinoma (TCC), Human leucocyte antigens (HLA), Immunity ÖZET Human Lökosit Antijenleri (HLA) tümör ve vücut savunması arasındaki etkileşimde bütünleyici rol oynayabilir. Biz çalışmamızda HLA sistemi ile mesane değişici epitel hücreli kanseri (DEHK) arasındaki ilişkinin varlığını göstermeye çalıştık. Çalışmamızda Terasaki’nin standart mikrolenfositotoksisite metodunu kullanarak mesanenin DEHK mevcut olan 30 hastanın HLA-A, B, DR ve DQ antijenlerinin tiplerini 30 sağlıklı kontrol grubu ile karşılaştırdık. DEHK hasta grubunda HLA-DQ6 (1) ve HLA-DQ7 (3) antijenleri kontrol grubundan istatistiksel açıdan anlamlı olarak yüksek bulundu (p=0.018, p=0.038). HLA-A10, B4,DR53 ve DQ1 antijenleri ise kontrol grubunda hasta grubuna göre anlamlı olarak yüksek bulundu (hepsinde p<0.05). Bulgularımız DEHK hasta grubundaki antijenleri taşıyan kişilerin DEHK için yüksek risk altında olduğunu, kontrol grubunda yüksek olarak bulunan doku antijenlerinin ise DEHK’den koruyucu özellikte olabileceğini düşündürdü. Gelecekte popülasyonumuzda yapılacak daha geniş çalışmalar bu bulguların gerçekliği konusunda daha aydınlatıcı olacaktır. HLA profillerinin gelecekte DEHK açısından risk altındaki kişilerin saptanmasında ve hastaların prognozu ile tedavileri açısından değerlendirebileceğini düşünüyoruz. Anahtar Kelimeler: Değişici epitel hücreli karsinom (DEHK), Human lökosit antijen (HLA), İmmunite Dergiye Geliş Tarihi: 20.01.2003 Yayına Kabul Tarihi: 30.12.2003 (Düzeltilmiş hali ile) 24 Türk Üroloji Dergisi: 30 (1): 24-28, 2004