Department of Surgery, General City Hospital Triemli, Zurich, Switzerland.
Int J Cancer. 2011 Jun 15;128(12):2947-52. doi: 10.1002/ijc.25836. Epub 2011 Feb 26.
Cancer testis antigens (CTAs) have been identified in various tumors as immunological tumor targets. In gastrointestinal stromal tumor (GIST), the prediction of malignant potential remains difficult but is crucial in the era of adjuvant imatinib treatment. Here, we analyzed the impact of CTAs on tumor recurrence and its role on the treatment response to imatinib. The expression of the most frequent CTAs MAGE-A1, MAGE-A3, MAGE-A4, MAGE-C1 and NY-ESO-1 was analyzed by immunohistochemistry. The duration between the initial operation and the tumor relapse was defined as recurrence free survival (RFS). All recurrent cases were treated with imatinib. The tumor response to imatinib was graded according to the modified CT response evaluation criteria. Patients with a CTA positive GIST (n = 23, 27%) had a significantly shorter RFS (p = 0.001) compared to negative cases (n = 63, 73%). The median RFS was 25 months in CTA positive patients and was not reached during the study period in CTA negative patients. According to the established staging criteria CTA positive tumors were predominantly high-risk tumors (p = 0.001). The expression of MAGE-A3 (p = 0.018) and NY-ESO-1 (p = 0.001) were associated with tumor progression under imatinib treatment. A tendency for worse tumor response to imatinib was observed in CTA positive tumors (p = 0.056). Our study confirms the expression of CTAs in GIST and their role as prognostic markers. It also draws attention to the potential impact of CTAs on the tumor response to imatinib.
癌症睾丸抗原 (CTA) 在各种肿瘤中被鉴定为免疫肿瘤靶标。在胃肠道间质瘤 (GIST) 中，恶性潜能的预测仍然很困难，但在辅助伊马替尼治疗时代至关重要。在这里，我们分析了 CTA 对肿瘤复发的影响及其对伊马替尼治疗反应的作用。通过免疫组织化学分析最常见的 CTA MAGE-A1、MAGE-A3、MAGE-A4、MAGE-C1 和 NY-ESO-1 的表达。将初始手术和肿瘤复发之间的时间定义为无复发生存期 (RFS)。所有复发病例均接受伊马替尼治疗。根据改良 CT 反应评估标准对伊马替尼的肿瘤反应进行分级。CTA 阳性 GIST 患者 (n = 23, 27%) 的 RFS 明显短于 CTA 阴性患者 (n = 63, 73%) (p = 0.001)。CTA 阳性患者的中位 RFS 为 25 个月，而 CTA 阴性患者在研究期间未达到。根据既定的分期标准，CTA 阳性肿瘤主要是高危肿瘤 (p = 0.001)。MAGE-A3(p = 0.018) 和 NY-ESO-1(p = 0.001) 的表达与伊马替尼治疗下的肿瘤进展相关。CTA 阳性肿瘤对伊马替尼的肿瘤反应较差的趋势 (p = 0.056)。我们的研究证实了 CTA 在 GIST 中的表达及其作为预后标志物的作用。它还引起了对 CTA 对伊马替尼肿瘤反应潜在影响的关注。
