Abstract
BACKGROUND: Cancer-testis antigens are typically expressed in malignant cells, germ-line cells, and the placenta. Given their potential as targets for cancer immunotherapy, it is essential to profile their expression. This study examines the clinical significance of MAGE-A4, LAGE-1, and NY-ESO expression levels in gastric cancer compared to normal tissues. METHODS: RNA was isolated from fresh gastric specimens of 76 patients diagnosed with GC before any therapeutic intervention. The Real-Time PCR evaluated the MAGE-A4, LAGE-1, and NY-ESO relative mRNA levels. Gene expression was normalized to GAPDH using the ΔΔCt method. Fold changes > 2 with p < 0.05 were considered statistically significant. RESULTS: The results indicated that the elevated mRNA expression levels of MAGE-A4, LAGE-1, and NY-ESO were observed in 21.05%, 22.38%, and 26.32% of the cases, respectively. Furthermore, a substantial upregulation of NY-ESO was noted in non-cardia tumors with T1/2 depth of invasion (p = 0.021). This marked increase in NY-ESO expression was also observed in primary-stage tumors situated in non-cardia regions (p = 0.026). MAGE-A4 expression tended to be higher in lymph node–negative tumors, while NY-ESO expression was associated with overall survival, and LAGE-1 showed variable expression. CONCLUSION: Our research demonstrates that MAGE-A4, LAGE-1, and NY-ESO expression are often upregulated in patients with GC. This overexpression in GC tumors is significantly associated with poor prognosis. Therefore, these may serve as a significant prognostic indicator for gastric cancer, and the cancer-testis antigens could represent a potential therapeutic target for a gastric cancer vaccine.