Abstract: Objective To investigate the expression of human leukocyte antigen⁃DRA (HLA⁃DRA) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological characteristics and prognosis. Methods A total of 273 pairs of HCC tissues and corresponding paracancerous tissues were retrospectively analyzed. The  expression of HLA⁃DRA protein were detected by immunohistochemistry method, and the clinicopathological characteristics of patients with different HLA⁃DRA protein expression levels were compared. The overall survival (OS) and recurrence⁃free survival (RFS) of patients with different HLA⁃DRA expression levels were compared by Log⁃rank method. Cox proportional hazards regression was used to assess the factors affecting OS and RFS of HCC patients after hepatectomy. Results The high expression rate of HLA⁃DRA protein in HCC tissues was lower than that in paracancerous tissues (39.19% vs 72.89%, χ² =62.927, P<0.001). The high HLA⁃DRA expression level was associated with AFP （alpha fetoprotein）>400 μg/L, cirrhosis, BCLC B/C stage, non⁃capsule/incomplete capsule, microvascular invasion (all P<0.05). The OS rate (χ² =4.336, P=0.037) and RFS rate (χ² =13.396, P<0.001) of HCC patients with high HLA⁃DRA expression were higher than those with low HLA⁃DRA expression. High expression of HLA⁃DRA protein was an independent protective factor for postoperative OS (HR=0.657, 95%CI: 0.492-0.898, P=0.021) and RFS (HR=0.668, 95%CI: 0.549-0.857, P=0.008) in HCC patients. Conclusions The high expression rate of HLA⁃DRA protein in HCC tissues is lower than that in paracancerous tissues, and its high expression is an independent protective factor for prognosis of HCC patients.

Key words: Hepatocellular carcinoma, HLA?DRA protein, Immunohistochemistry, Expression, Prognosis