Is poor prognosis really related to HLA-DR expression by malignant melanoma cells?

HLA-DR expression was examined in 50 consecutive primary cutaneous malignant melanomas with a Breslow depth greater than 2 mm using two well-characterized monoclonal antibodies which detect fixation-resistant epitopes. In 31 of these cases (62%) a subpopulation of tumour cells was reactive, although there was considerable heterogeneity. Positive labelling did not correlate with depth but was associated with a reduced likelihood of developing early metastatic disease and a tendency for better overall survival, particularly in male patients. These findings contrast with earlier studies using cryostat sections and one study on paraffin-embedded tissue in which HLA-DR expression was shown to be a poor prognostic factor, but are consistent with the findings in other malignant tumours studied. The significance of HLA-DR expression as a marker of prognosis may depend on the type of tissue preparation, the sensitivity of the immunocytochemical techniques used and the method of assessment.