MAGE-A4 and MAGE-A1 Immunohistochemical Expression in High-grade Endometrial Cancer

Int J Gynecol Pathol. 2019 Jan;38(1):59-65. doi: 10.1097/PGP.0000000000000470.

Abstract

The aim was to investigate MAGE-A4 and MAGE-A1 protein expression in high-grade endometrial cancer and determine its correlation with histologic subtype, FIGO stage, presence of vascular invasion, disease free, and overall survival. Immunohistochemical staining was performed by using 77B (MAGE-A1) and 57B (MAGE-A4) monoclonal antibodies on paraffin-embedded sections from high-grade endometrial cancers diagnosed in University Hospital Split between 1998 and 2011 (n=77). Median follow-up time for survivors was 48 mo. MAGE-A4 was found to be expressed in 33% of endometrioid type endometrial cancers grade 3 and in 27% of serous and clear cell carcinomas. MAGE-A1 was found to be expressed in 93% endometrioid endometrial cancer grade 3 and 86% of serous and clear cell carcinomas. Univariate analysis showed that positive immunohistochemical staining for MAGE-A4 was associated with decreased disease free and overall survival in patients with high-grade endometrial cancer. Multivariate analysis showed an association between MAGE-A4 overexpression and decreased disease free but not overall survival in high-grade endometrial cancer. No correlation was found between MAGE-A1 immunohistochemical expression and patient survival. There was no significant correlation between MAGE-A4 and MAGE-A1 expression and histologic subtype, FIGO stage, lymph node metastasis, muscular infiltration, and lymphovascular invasion. MAGE-A4 immunohistochemical expression is associated with decreased disease free and overall survival in patients with high-grade endometrial cancer. Our findings suggest that MAGE-A1 may be expressed in the epithelial cells of the normal endometrium. MAGE-A1 is highly expressed in high-grade endometrial cancer, with no impact on survival.

MeSH terms

  • Adenocarcinoma, Clear Cell / metabolism
  • Adenocarcinoma, Clear Cell / mortality
  • Adenocarcinoma, Clear Cell / pathology*
  • Antibodies, Monoclonal
  • Antigens, Neoplasm / metabolism*
  • Carcinoma, Endometrioid / metabolism
  • Carcinoma, Endometrioid / mortality
  • Carcinoma, Endometrioid / pathology*
  • Endometrial Neoplasms / metabolism
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology*
  • Endometrium / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphatic Metastasis
  • Neoplasm Grading
  • Neoplasm Proteins / metabolism*
  • Peptide Fragments / metabolism*
  • Retrospective Studies
  • Survival Analysis

Substances

  • Antibodies, Monoclonal
  • Antigens, Neoplasm
  • MAGE-A1 protein (278-286), human
  • MAGEA4 protein, human
  • Neoplasm Proteins
  • Peptide Fragments