Prognostic relevance of MAGE-A4 tumor antigen expression in transitional cell carcinoma of the urinary bladder: a tissue microarray study

Int J Cancer. 2002 Aug 20;100(6):702-5. doi: 10.1002/ijc.10540.


TAAs of the MAGE family are mostly studied as targets of specific immune responses. Their potential relevance as tumor markers has also been underlined. We used a MAb, 57B, recognizing MAGE-A4 protein in paraffin-embedded sections, to evaluate its expression in bladder cancers by employing TMA including 2,317 samples from 1,849 patients. In 2,090/2,317 cases (90.2%), immunostaining yielded interpretable results. Since for some patients more than 1 sample was available, only interpretable first biopsies (n = 1,628) were considered. MAGE-A4 protein was expressed at significantly (p < 0.001) higher frequency in squamous (25/55, 45.5%) than in adeno (4/15, 26.7%), sarcomatoid (4/14, 28.6%), small cell (5/20, 25%) or transitional cell (281/1,522, 18.5%) carcinomas. In TCCs, overall MAGE-A4 positivity was significantly correlated with invasive phenotype (p < 0.001) and high tumor grade (p < 0.0001). Clinical data from 908 TCC patients were retrospectively evaluated, revealing that strong 57B staining was highly significantly associated with decreased tumor-specific survival (p < 0.0001). These data suggest that evaluation of MAGE-A4 protein expression is useful in the identification of groups of TCCs characterized by severe prognosis, thus possibly providing indications for early MAGE TAA-targeted immunotherapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / metabolism
  • Antigens, Neoplasm / biosynthesis*
  • Carcinoma, Transitional Cell / metabolism*
  • Epitopes
  • Humans
  • Immunohistochemistry
  • Neoplasm Proteins*
  • Oligonucleotide Array Sequence Analysis
  • Phenotype
  • Prognosis
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder / metabolism*
  • Urinary Bladder Neoplasms / metabolism


  • Antibodies, Monoclonal
  • Antigens, Neoplasm
  • Epitopes
  • MAGEA4 protein, human
  • Neoplasm Proteins