Figure 1: HHLA2 is expressed in the majority of osteosarcoma tumors.

(A) representative tumors for each HHLA2 grade based on IHC. The ICH scores were based on the percentage of tumor cells that were HHHLA2 positive, with the five subdivisions being: negative, less than 25% positive, 25% ≤ HHLA2 < 50%, 51% ≤ HHLA2 < 75%, and equal or greater than 75% positive. Scale bar, 100 μM. (B) The majority of tumors examined were HHLA2 positive at all times of diseases progression. There is a significant decrease in HHLA2 positive cells between the time of biopsy and definitive surgery (77% vs 53%, p = 0.03). Metastatic samples have a higher percentage of cells staining positive for HHLA2 when compared to samples at definitive surgery (93% vs 53%, p = 0.01) and at biopsy (93% vs 77%, p = 0.001). (C) HHLA2 expression was sorted into three groups based on tissue type and presence of metastasis: primary tissue with metastasis, primary tissue without metastasis, and metastatic tissue. The percentage of cells expressing HHLA2 is significantly increased in metastatic tissue compared to primary tissue without presence of metastatic disease (53% vs 93%, p = 0.02).