Prognostic relevance of MAGE-A4 tumor antigen expression in transitional cell carcinoma of the urinary bladder: a tissue microarray study.
TAAs of the MAGE family are mostly studied as targets of specific immune responses. Their potential relevance as tumor markers has also been underlined. We used a MAb, 57B, recognizing MAGE-A4 protein in paraffin-embedded sections, to evaluate its expression in bladder cancers by employing TMA including 2,317 samples from 1,849 patients. In 2,090/2,317 cases (90.2%), immunostaining yielded interpretable results. Since for some patients more than 1 sample was available, only interpretable first biopsies (n = 1,628) were considered. MAGE-A4 protein was expressed at significantly (p < 0.001) higher frequency in squamous (25/55, 45.5%) than in adeno (4/15, 26.7%), sarcomatoid (4/14, 28.6%), small cell (5/20, 25%) or transitional cell (281/1,522, 18.5%) carcinomas. In TCCs, overall MAGE-A4 positivity was significantly correlated with invasive phenotype (p < 0.001) and high tumor grade (p < 0.0001). Clinical data from 908 TCC patients were retrospectively evaluated, revealing that strong 57B staining was highly significantly associated with decreased tumor-specific survival (p < 0.0001). These data suggest that evaluation of MAGE-A4 protein expression is useful in the identification of groups of TCCs characterized by severe prognosis, thus possibly providing indications for early MAGE TAA-targeted immunotherapy.
Kocher
Thomas
T
General Surgery Service, Department of Surgery, University Hospital of Basel, Hebelstrasse 20, CH-4031 Basel, Switzerland.
Zheng
Min
M
Bolli
Martin
M
Simon
Ronald
R
Forster
Thomas
T
Schultz-Thater
Elke
E
Remmel
Eugenia
E
Noppen
Christoph
C
Schmid
Ulrico
U
Ackermann
Daniel
D
Mihatsch
Michael J
MJ
Gasser
Thomas
T
Heberer
Michael
M
Sauter
Guido
G
Spagnoli
Giulio C
GC
D000911:Antibodies, Monoclonal / Q000378:metabolism; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D002295:Carcinoma, Transitional Cell / Q000378:metabolism*; D000939:Epitopes; D006801:Humans; D007150:Immunohistochemistry; D009363:Neoplasm Proteins; D020411:Oligonucleotide Array Sequence Analysis; D010641:Phenotype; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000378:metabolism*; D001749:Urinary Bladder Neoplasms / Q000378:metabolism
D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D000939:Epitopes; C095204:MAGEA4 protein, human; D009363:Neoplasm Proteins