title: Cancer-testis genes are coordinately expressed and are markers of poor outcome in non-small cell lung cancer.
abstract: OBJECTIVE
  Cancer-testis genes mapping to the X chromosome have common expression patterns and show similar responses to modulators of epigenetic mechanisms. We asked whether cancer-testis gene expression occurred coordinately, and whether it correlated with variables of disease and clinical outcome of non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Tumors from 523 NSCLC patients undergoing surgery were evaluated for the expression of nine cancer-testis genes (NY-ESO-1, LAGE-1, MAGE-A1, MAGE-A3, MAGE-A4, MAGE-A10, CT7/MAGE-C1, SSX2, and SSX4) by semiquantitative PCR. Clinical data available for 447 patients were used to correlate cancer-testis expression to variables of disease and clinical outcome.
  
  
  RESULTS
  At least one cancer-testis gene was expressed by 90% of squamous carcinoma, 62% of bronchioloalveolar cancer, and 67% of adenocarcinoma samples. Statistically significant coexpression was observed for 34 of the 36 possible cancer-testis combinations. Cancer-testis gene expression, either cumulatively or individually, showed significant associations with male sex, smoking history, advanced tumor, nodal and pathologic stages, pleural invasion, and the absence of ground glass opacity. Cox regression analysis revealed the expression of NY-ESO-1 and MAGE-A3 as markers of poor prognosis, independent of confounding variables for adenocarcinoma of the lung.
  
  
  CONCLUSIONS
  Cancer-testis genes are coordinately expressed in NSCLC, and their expression is associated with advanced disease and poor outcome.
authors.affiliation: Ludwig Institute for Cancer Research, Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA. agure@med.cornell.edu
authors.forename: Ali O
authors.initials: AO
authors.lastname: Gure
authors.forename: Ramon
authors.initials: R
authors.lastname: Chua
authors.forename: Barbara
authors.initials: B
authors.lastname: Williamson
authors.forename: Mithat
authors.initials: M
authors.lastname: Gonen
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Ferrera
authors.forename: Sacha
authors.initials: S
authors.lastname: Gnjatic
authors.forename: Gerd
authors.initials: G
authors.lastname: Ritter
authors.forename: Andrew J G
authors.initials: AJ
authors.lastname: Simpson
authors.forename: Yao-T
authors.initials: YT
authors.lastname: Chen
authors.forename: Lloyd J
authors.initials: LJ
authors.lastname: Old
authors.forename: Nasser K
authors.initials: NK
authors.lastname: Altorki
mesh_terms: D000951:Antigens, Neoplasm / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000235:genetics; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000473:pathology; D041321:Chromosomes, Human, X / Q000235:genetics; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D008297:Male; D008565:Membrane Proteins / Q000235:genetics*; D008875:Middle Aged; D011379:Prognosis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016019:Survival Analysis; D013737:Testis / Q000378:metabolism
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D008565:Membrane Proteins