Abstract
Melanoma antigen gene A3 (MAGE-A3) is one of the most immunogenic cancer testis antigens and is common in various types of cancers. In this study, for the first time, we performed immunohistochemical analysis to evaluate the expression of MAGE-A3 in 153 prostate tissue samples including prostate cancer (PCa), benign prostatic hyperplasia (BPH), and high-grade prostatic intraepithelial neoplasia (HPIN). Increased both nuclear and cytoplasmic expression of MAGE-A3 was significantly found in PCa tissues compared with both HPIN and BPH tissues (nuclear expression at p=0.011, and cytoplasmic expression at p=0.034; for both comparisons p<0.0001, respectively). A significant correlation was observed between higher nuclear and cytoplasmic expressions of MAGE-A3 with Gleason score (p<0.0001 and 0.006, respectively). Increased expression of MAGE-A3 was associated with shorter biochemical recurrence-free survival (BCR-FS) and disease-free survival (DFS) of patients (p=0.042 and =0.0001, respectively). In multivariate analysis, nuclear expression of MAGE-A3 and Gleason score (≤7 vs >7) was independent predictors of the DFS (both; p=0.019). Nuclear expression of MAGE-A3 was also significantly related to BCR-FS (p=0.015). MAGE-A3 can be considered as a predictor for poor prognosis and an option for vaccine immunotherapy in patients with PCa.
Highlights
Prostate cancer (PCa) is the second most common cancer among the world's male population and has been identified as the sixth leading cause of cancer deaths in the world
There was no significant association between cytoplasmic expression of Melanoma antigen gene A3 (MAGE-A3) with biochemical recurrence (BCR) and disease-free survival (DFS) of patients (P = 0.504, P = 0.115, respectively) (Fig. 4C and D). These results showed that biochemical recurrence-free survival (BCR-FS) and DFS rates were significantly longer for patients whose tumors were classified as low expression for nuclear MAGE-A3 expression, as compared with patients whose tumors were classified as high expression for nuclear MAGE-A3
Hudolin et al performed immunohistochemical analysis by staining multiple melanoma antigen gene A (MAGE-A) on 30 samples in patients with penile carcinoma and 92 prostate cancer (PCa)
Summary
Prostate cancer (PCa) is the second most common cancer among the world's male population and has been identified as the sixth leading cause of cancer deaths in the world. The growth of the tumor is slow and asymptomatic in many patients and in some cases progresses over time and spreads to other parts of the body, including bone and lymph nodes. Common treatments for patients with localized PCa include surgery (radical prostatectomy) and radiotherapy (brachytherapy or external beam radiotherapy), and patients are monitored after an initial treatment. The use of androgen ablation is initially associated with high efficacy, it has significant side effects and, for some patients whose life span is prolonged, the disease eventually spreads to advanced metastatic castration-resistant PCa (mCRPC). Due to the challenging conditions of mCRPC patients, it is important to develop therapeutic strategies with higher efficacy and lower side effects [3, 4]
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