MAGE-A expression, immune microenvironment, and prognosis in upper urinary tract carcinoma

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• 作者：Naohiro Makise ; MD^a ; Teppei Morikawa ; MD ; PhD^a ; ^{tmorikawa-tky@umin.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Tohru Nakagawa ; MD ; PhD^b ; Takashi Ichimura ; MD ; PhD^a ; Taketo Kawai ; MD ; PhD^b ; Hirokazu Matsushita ; MD ; PhD^c ; Kazuhiro Kakimi ; MD ; PhD^c ; Haruki Kume ; MD ; PhD^b ; Yukio Homma ; MD ; PhD^b ; Masashi Fukayama ; MD ; PhD^a
• 关键词：Cancer-testis antigen ; Immunohistochemistry ; Immunotherapy ; Survival ; Urothelial carcinoma
• 刊名：Human Pathology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：50
• 期：Complete
• 页码：62-69
• 全文大小：729 K

文摘

The melanoma-associated antigen A (MAGE-A) family comprises cancer-testis antigens that represent promising prognostic biomarkers and immunotherapy targets in several cancer types. The aim of this study was to investigate the significance of MAGE-A expression in upper urinary tract urothelial carcinoma in relation to clinicopathological features, lymphocytic infiltration, and clinical outcome. We immunohistochemically examined the expression of MAGE-A in 171 patients with upper urinary tract urothelial carcinoma. High (≥50% positive) and low MAGE-A expression levels were observed in 33 (19%) and 49 (29%) cases, respectively. MAGE-A was negative in 89 cases (52%). MAGE-A expression was positively correlated with high histologic grade; concomitant carcinoma in situ; higher Ki-67 proliferation index; and infiltration of CD3-, CD8-, and CD45RO-positive T lymphocytes, but not with CD20-positive B lymphocytes. High MAGE-A expression was significantly associated with shorter metastasis-free survival after nephroureterectomy (log-rank P = .019; multivariate hazard ratio, 1.98; 95% confidence interval, 1.00-3.92). MAGE-A expression in metastatic lymph nodes was highly correlated with its expression in primary lesions. MAGE-A expression was retained in chemotherapy-resistant metachronous metastatic lesions of urothelial carcinoma. MAGE-A may be a promising prognostic biomarker and potential immunotherapeutic target for patients with upper urinary tract urothelial carcinoma.