engleski

Expression and possible prognostic role of MAGE-A4, NY-ESO-1 and HER-2 antigens in patients with relapsing invasive ductal breast cancer: a retrospective immunohistochemical study.

Aim To evaluate the possible prognostic role of the expression of MAGEA4 and NY-ESO-1 cancer/testis antigens in women diagnosed with invasive ductal breast cancer and determine the expression of HER-2 antigen. Methods The expression of MAGE-A4, NY-ESO-1, and HER-2 antigens was evaluated immunohistochemically on archival paraffi n-embedded samples of breast cancer tissue from 81 patients. All patients had T1 to T3, N0 to N1, M0 tumors and underwent postoperative radiotherapy and, if indicated, systemic therapy (chemotherapy and hormonal therapy). Th e antigen expression in women who were disease-free for 5 years of follow up (n = 23) was compared with that in women with either locoregional relapse (n = 30) or bone metastases (n = 28). Patient survival aft er 10 years of follow up was assessed. Results The three groups of women were comparable in terms of age, type of operation, tumor size, tumor grade, number of metastatically involved axillary lymph nodes, Nottingham prognostic index (NPI), progesterone receptor (PR) status, and adjuvant hormonal therapy. Estrogen receptors (ER) were positive in 13 women in the 5-year relapse-free group vs 8 in locoregional relapse and 7 in bone metastases group (P = 0.032). Th ere were significantly fewer women who received adjuvant chemotherapy in the 5-year relapse-free group than in other two groups (7 vs 23 with locoregional relapse and 25 with bone metastases ; P<0.001). Th is group also had a significantly better 10-year survival (14 women vs 1 with locoregional relapse and 1 with bone metastases ; P<0.001). The three groups did not diff er in the NY-ESO-1 or HER-2 expression, but the number of patients expressing MAGE-A4 antigen was signifi cantly lower in the group with locoregional relapse (P = 0.014). In all groups, MAGE-A4 antigen expression was associated with the NY-ESO-1 antigen expression (P = 0.006), but not with tumor size and grade, number of metastatically involved axillary lymph nodes, or the ER and PR status. MAGE-A4-positive patients had a significantly longer survival than the MAGE-A4-negative patients (P = 0.046). This was not observed with NY-ESO-1 and HER-2 antigens. Conclusion Our results suggest that the MAGE-A4 antigen may be used as a tumor marker of potential prognostic relevance.

Breast cancer; cancer/testis (C/T) antigens; HER-2 immunoreactivity; immunohistochemistry; MAGE-A4 immunoreactivity; NY-ESO-1 immunoreactivity; tumor antigens

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