The expression of the cancer testis antigen MAGE A4: A favorable prognostic biomarker in salivary gland carcinomas related to low tumor grading

BACKGROUND: Aim was to analyze the expression of different cancer testis antigens (CTA) and to assess its prognostic value in salivary gland carcinomas. METHODS: Patients with salivary gland carcinomas diagnosed 1994 to 2010 were included. Baseline characteristics, pathohistological, clinical, and outcome data were assessed. Tissue microarrays were constructed and immunohistochemistry for different CTA (NY‐ESO1, NY‐BR1, MAGE A1, MAGE A3, MAGE A4, MAGE C1/CT7, and MAGE C2/CT10) was performed. CTA expression was assessed and statistically correlated with pathological and outcome data. RESULTS: Expression rates of CTA in salivary gland tumors ranged from 0% to 40%. MAGE A4 expression was associated with a lower tumor grade tumor grading (P = .017), and a favorable recurrence‐free (P = .003), disease‐specific (P = .046) and overall survival (P = .028). CONCLUSIONS: MAGE A4 is a highly significant prognostic marker in salivary gland carcinoma; its expression is associated with low‐grade histology, a low rate of distant metastasis and a favorable survival. LEVEL OF EVIDENCE: 4