title: Overexpression of MAGE-A9 predicts unfavorable outcome in breast cancer.
abstract: Melanoma-associated antigens (MAGEs) are a group of well-characterized members of the cancer/testis antigen (CTA) family, which is one of the largest groups of human tumor-associated antigens. MAGE-A9 is a particular member in the context of the MAGE-A gene family and was defined as presenting prognostic relevance in certain type of human cancer. However, the expression of MAGE-A9 in invasive ductal breast cancer (IDC) and the relationship with the clinical attributes of IDC, especially prognostic characteristic, remain poorly understood. In this present study, one-step quantitative reverse transcription polymerase chain reaction (18 fresh-frozen IDC tissues and corresponding non-cancerous tissues) and immunohistochemistry by tissue microarrays (82 IDC tissue samples and 70 matched tumor-adjacent non-cancerous tissue samples) were performed to characterize expression of the MAGE-A9 gene in IDC. Kaplan-Meier survival and Cox regression analyses were performed to evaluate the prognosis of IDC. The results of qPCR and IHC analysis showed that the expression of MAGE-A9 in IDC was significantly higher than that in corresponding non-cancerous tissue. Moreover, the expression level of MAGE-A9 protein in IDC was significantly related to histological grade (p = 0.011) and distant metastasis (p = 0.019). Multivariate analysis with the Cox regression model showed that MAGE-A9 protein expression (p = 0.009), histological grade (p = 0.014), lymph node metastasis (p = 0.012) and distant metastasis (p = 0.011) were independent prognostic factors for overall survival of IDC patients. The data suggest that MAGE-A9 expression is correlated with malignant attributes of IDC and it may serve as a novel prognostic factor and an ideal candidate for targeted therapy in IDC treatment.
authors.affiliation: The Key Laboratory of Cancer Biomarkers, Prevention & Treatment Cancer Center, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; The Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: The Key Laboratory of Cancer Biomarkers, Prevention & Treatment Cancer Center, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; The Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210011, China.
authors.forename: Meiping
authors.initials: M
authors.lastname: Lu
authors.affiliation: The Key Laboratory of Cancer Biomarkers, Prevention & Treatment Cancer Center, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; The Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.affiliation: Department of Gynecology and Obstetrics, Nanjing Maternal and Children Care Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Affiliated Hospital of Nantong University, No. 20 Xisi Road, Nantong 226001, China.
authors.forename: Huijun
authors.initials: H
authors.lastname: Zhu
authors.affiliation: The Key Laboratory of Cancer Biomarkers, Prevention & Treatment Cancer Center, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; The Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Xu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Nanjing Medical University, No. 121 Jiang Jia Yuan, Nanjing 210011, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, No. 121 Jiang Jia Yuan, Nanjing 210011, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Jiangsu Provincial Hospital, No. 65 Jiangsu Road, Nanjing 210029, China. Electronic address: ymaoent@yahoo.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Mao
authors.affiliation: The Key Laboratory of Cancer Biomarkers, Prevention & Treatment Cancer Center, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; The Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, No. 140 Hanzhong Road, Nanjing 210029, China; Huadong Medical Institute of Biotechniques, No. 293 Zhongshan Dong Road, Nanjing 210002, China. Electronic address: zhujin1968@njmu.edu.cn.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D046888:Tissue Array Analysis; D015854:Up-Regulation
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; C520253:MAGEA9 protein, human; D009363:Neoplasm Proteins
keywords: IDC; Immunohistochemistry; MAGE-A9; Prognosis; Tissue microarray; qPCR