目的：探讨黑素瘤相关抗原（melanoma antigen，MAGE）-A9 和-A11在食管鳞状细胞癌组织中的表达情况，分析其与食管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年9月至2010年11月住院手术切除的食管癌组织及距癌组织边缘5 cm以上且病理诊断证实为正常组织的癌旁组织标本各60例，同时选取5例该院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食管鳞状细胞癌组织及相应癌旁组织中MAGE-A9和-A11蛋白的表达。结果： 食管鳞状细胞癌组织中MAGE-A9和 MAGE-A11 蛋白的阳性表达率分别为 45%（27/60）和66.67%（40/60），而相应的癌旁组织未发现MAGE-A9和-A11蛋白的表达。MAGE-A9蛋白的表达与食管鳞状细胞癌患者的年龄、临床分期、肿瘤大小、淋巴转移均无相关性（P>0.05），但与组织学分级相关（P<0.05）；MAGE-A11蛋白表达与食管鳞状细胞癌患者的年龄、组织学分级、淋巴转移均无相关性（P>0.05），但与临床分期、肿瘤大小呈正相关（P<0.05）。Log-Rank检验显示，MAGE-A9 （P=0.037）和-A11（P=0.039）蛋白表达阳性的食管鳞状细胞癌患者和贲门腺癌患者的生存期均显著低于其表达阴性的患者。Cox多因素分析提示，MAGE-A9(P=0.026)和MAGE-A11(P=0.038)蛋白表达、组织学分级(P=0.026)、临床分期(P=0.008)及淋巴结转移(P=0.010)可作为整体生存的独立预后因素。结论： MAGE-A9和-A11蛋白是食管鳞状细胞癌的特异性抗原，似可作为食管鳞状细胞癌预后不良的预测指标。

Objective:To investigate the expression of melanoma antigen (MAGE)-A9 and MAGE-A11 in esophageal squamous cell carcinomas in association with major clinical and biological variables. Methods: Cancerous (n=60）and adjacent (n=60) esophageal tissue specimens were collected from 60 patients with esophageal squamous cell carcinomas who underwent surgery in Hebei Medical University-Affiliated Fourth Hospital between September and November 2010. Testicular tissue specimens were collected from 5 prostate cancer patients in the same time as positive controls. MAGE-A9 and MAGE-A11 in these tissue specimens were assessed by immmuohistochemical staining. Correlations of MAGE-A9 and MAGE-A11 levels with patients' major clinical and demographic variables were determined. Results:MAGE-A9 and -A11 were positive in 45% (27/60) and 66.67% (40/60) of cancerous tissue specimens respectively but were both negative in tumor-adjacent tissue specimens. While MAGE-A9 protein was not correlated with age, clinical stage, tumor size, and lymph node metastasis(P>0.05), it was significantly correlated with the histological grade of the lesion in patients with esophageal squamous cell carcinoma (P<0.05). While MAGE-A11 protein was not correlated with age, histological grade, lymph node metastasis (P>0.05), it was significantly correlated with clinical stage and tumor size (P<0.05) in patients with esophageal squamous cell carcinoma. Log-rank test showed that the survival time was significantly shorter in MAGE-A9-positive (P=0.037) and MAGE-A11 positive (P=0.039) patients than in MAGE-A9-negative and MAGE-A11-negative patients. Cox multivariate analysis suggested that MAGE-A9 protein (P=0.026), MAGE-A11 protein (P=0.038), histological grade (P=0.026), TNM stage (P=0.008) and lymph node metastasis (P=0.010) were independent prognostic factors for overall survival. Conclusion: MAGE-A9 and -A11 are esophageal squamous cell carcinoma-specific antigens, thus having potential diagnostic and prognostic significance in clinical settings.

河北省财政支撑项目资助（No. \[2012\]2056); 河北省科技支撑计划项目资助（No.14277732D）