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目的黑色素瘤相关抗原(melanoma antigen,MAGE)在肿瘤的发生发展中起重要作用,而MAGE-A9和MAGE-A11在贲门腺癌组织中表达与临床病理学特征之间的关系仍不清楚。本研究旨在探讨MAGE-A9和MAGE-A11在贲门腺癌组织中的表达,分析其与贲门腺癌患者临床病理学特征及其预后的关系。方法选取河北医科大学第四医院2010-09-15-2010-11-15住院手术切除的贲门腺癌组织及距离癌组织边缘>5cm且外观正常的相应癌旁组织标本各60例,同时选取5例该院同期前列腺癌住院患者术后的睾丸组织作为阳性对照。应用免疫组织化学法检测贲门腺癌组织及相应癌旁组织中MAGE-A9和MAGE-A11蛋白的表达。结果贲门腺癌组织中MAGE-A9和MAGE-A11蛋白的阳性表达率分别为40.0%(24/60)和51.7%(31/60),而相应的癌旁组织未发现MAGE-A9和MAGE-A11蛋白的表达。MAGE-A9蛋白表达与贲门腺癌患者的性别(χ2=0.062,P=0.803)、年龄(χ2=0.179,P=0.673)、临床分期(χ2=2.791,P=0.248)、肿瘤大小(χ2=0.014,P=0.993)和淋巴转移(χ2=0.128,P=0.721)均无相关性,但与组织学分级相关(χ2=10.437,P=0.005)。MAGE-A11蛋白表达与贲门腺癌患者的性别(χ2=0.020,P=0.887)、年龄(χ2=2.530,P=0.190)、肿瘤大小(χ2=2.550,P=0.279)和淋巴转移(χ2=2.550,P=0.110)均无相关性,但与临床分期(χ2=15.095,P=0.001)和组织学分级(χ2=13.424,P=0.001)呈正相关。Log-Rank检验结果显示,MAGE-A9和MAGE-A11蛋白表达阳性的贲门腺癌患者的生存期均显著低于其表达阴性的患者,χ2值分别为5.317和6.082,P值分别为0.021和0.014。Cox多因素分析提示,MAGE-A9蛋白表达(HR=3.304,P=0.015)、MAGE-A11蛋白表达(HR=2.933,P=0.006)、组织学分级(HR=2.018,P=0.034)及临床分期(HR=2.532,P=0.004)可作为整体生存的独立预后因素。结论 MAGE-A9和MAGE-A11蛋白是贲门腺癌的特异性抗原。MAGE-A9和MAGE-A11蛋白可作为贲门腺癌预后不良的预测指标。
Objective The expression of melanoma antigen (MAGE) plays an important role in the tumorigenesis. The relationship between the expression of MAGE-A9 and MAGE-A11 in gastric cardia adenocarcinoma and clinicopathological features remains unclear. This study aimed to investigate the expression of MAGE-A9 and MAGE-A11 in gastric cardia adenocarcinoma and to analyze the relationship between the expression of MAGE-A9 and clinicopathological characteristics and their prognosis in patients with GCA. Methods The fourth hospital of Hebei Medical University 2010-09-15-2010-11-15 hospitalized gastric cardia adenocarcinoma and cancer tissue from the edge of> 5cm and the appearance of normal corresponding adjacent tissue specimens of 60 cases, while selecting 5 Cases of hospitalized patients with prostate cancer in the same period of testicular tissue as a positive control. Immunohistochemistry was used to detect the expression of MAGE-A9 and MAGE-A11 in gastric cardia adenocarcinoma tissues and corresponding paracancerous tissues. Results The positive rates of MAGE-A9 and MAGE-A11 in GCA were 40.0% (24/60) and 51.7% (31/60), respectively. However, MAGE-A9 and MAGE- A11 protein expression. MAGE-A9 protein expression was significantly associated with GCA (χ2 = 0.062, P = 0.803), age (χ2 = 0.179, P = 0.673), clinical stage 0.014, P = 0.993) and lymph node metastasis (χ2 = 0.128, P = 0.721), but not with histological grade (χ2 = 10.437, P = 0.005). The expression of MAGE-A11 in patients with GCA was significantly higher than that in patients with GCA (χ2 = 0.020, P = 0.887), age (χ2 = 2.530, P = 0.190), tumor size 2.550, P = 0.110), but it was positively correlated with clinical stage (χ2 = 15.095, P = 0.001) and histological grade (χ2 = 13.424, P = 0.001) Log-Rank test showed that patients with MAGE-A9 and MAGE-A11 positive GCA patients had significantly lower survival than those with negative expression, withχ2 values of 5.317 and 6.082, P values of 0.021 and 0.014 . Cox multivariate analysis showed that the expression of MAGE-A9 protein (HR = 3.304, P = 0.015), MAGE-A11 protein expression (HR = 2.933, P = 0.006) Staging (HR = 2.532, P = 0.004) was an independent prognostic factor for overall survival. Conclusion MAGE-A9 and MAGE-A11 proteins are specific antigens of gastric cardia adenocarcinoma. MAGE-A9 and MAGE-A11 proteins may serve as predictors of poor prognosis in gastric cardia adenocarcinoma.