目的：探讨黑色素瘤相关抗原（melanoma antigen，MAGE）As在非小细胞肺癌（Nonsmall cell carcinoma，NSCLC）组织中的表达，并分析其与临床病理学特征和预后的关系。方法：选取河北医科大学第四医院2015年9月至2016年3月住院手术切除的NSCLC组织及相应癌旁组织标本90例，应用免疫组织化学法检测NSCLC组织及相应癌旁组织中MAGEAs蛋白的表达，分析MAGEAs蛋白表达与NSCLC临床病理指标之间的相关性；利用荧光原位杂交技术检测EGFR基因扩增和ALK基因重排情况，Spearman检验MAGEA表达与EGFR扩增和ALK重排的关系；应用KaplanMeier方法对NSCLC患者是否阳性表达MAGEAs蛋白进行生存分析，利用Cox回归模型针对阳性表达MAGEAs及相关的临床病理资料进行单因素和多因素分析。结果：NSCLC组织中MAGEAs 蛋白的阳性表达率明显高于癌旁组织（P<0.05）。MAGEAs蛋白的表达与患者的临床病理学特征、EGFR扩增和ALK重排均无关联（P>0.05）。MAGEAs蛋白表达阳性的NSCLC患者生存期显著低于其表达阴性患者（P<0.05）,而EGFR扩增和ALK重排与患者的整体生存率无关（P>0.05）。多因素分析结果显示，MAGEAs表达、临床分期和淋巴结转移是NSCLC患者较差预后的独立危险因素。结论：MAGEAs蛋白是NSCLC的相关抗原，MAGEAs蛋白可作为NSCLC患者预后不良的预测指标。

Objective:To investigate the expression of melanoma antigen (MAGE)As in nonsmall cell carcinoma (NSCLC), and to explore its correlation with clinical pathological indicators and the prognosis. Methods: NSCLC tissue samples (n=90) and paracarcinoma tissue samples (n=90) were collected from 90 patients with NSCLC who were surgically treated in Fourth Hospital of Hebei Medical University between September of 2005 and March of 2006. The expression of MAGEAs protein in the 90 paired tissues was detected by immunohistochemistry assay, and its correlation to NSCLC clinical pathological indicators was analyzed. In addition, EGFR amplification and ALK rearrangements of NSCLC patients were detected by fluorescent in situ hybridization, and the association between MAGEAs expression and EGFR amplification and ALK rearrangements was analyzed with Spearman correlation analysis. The survival of NSCLC patients with positive MAGEAs expression was analyzed by KaplanMeier method. Cox regression model was used for univariate analysis and multivariate analysis of correlations between positive expression of MAGEAs and clinical pathological indicators. Results: The positive rates of MAGEAs protein in NSCLC were significantly higher than that of noncancerous tissues (P<0.05). MAGEAs expression was not correlated with clinical pathological indicators of NSCLC patients, EGFR amplification and ALK rearrangements(P>0.05). Logrank test showed that the survival time of NSCLC patients with positive MAGEAs expression were lower than those with negative expression (P<0.05); However, EGFR amplification and ALK rearrangements were not associated with the overall survival of NSCLC patients. Results from multivariate analyses showed that the expression of MAGEAs, clinical stage, lymph node metastasis were independent risk factors of NSCLC. Conclusion: MAGEAs proteins are NSCLCassociated antigens, thus having potential diagnostic and prognostic significance in clinical settings.

河北省财政支撑资助项目(No. 20141257)；河北省杰出青年基金资助项目（No.H2016206410）；河北省财政厅资助项目(No. 2016361006)