Evaluation of MAGE-A expression and grade of dysplasia for predicting malignant progression of oral leukoplakia

Ries,Jutta; Agaimy,Abbas; Vairaktaris,Elefterios; Kwon,Yeeun; Neukam,Friedrich  W.; Strassburg,Lei  H.; Nkenke,Emeka

doi:10.3892/ijo.2012.1532

Evaluation of MAGE-A expression and grade of dysplasia for predicting malignant progression of oral leukoplakia

Authors:
- Jutta Ries
- Abbas Agaimy
- Elefterios Vairaktaris
- Yeeun Kwon
- Friedrich W. Neukam
- Lei H. Strassburg
- Emeka Nkenke
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Affiliations: Department of Oral and Maxillofacial Surgery, Erlangen University Hospital, Erlangen, Germany, Institute of Pathology, Erlangen University Hospital, Erlangen, Germany, Department of Oral and Maxillofacial Surgery, University of Athens, Athens, Greece
Published online on: June 26, 2012 https://doi.org/10.3892/ijo.2012.1532
Pages: 1085-1093

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Abstract

The risk of the malignant transformation of oral leukoplakia (OLP) is difficult to predict by histopathology. Melanoma-associated antigen-A (MAGE-A) expression is restricted to malignant cells and may be useful for the more accurate estimation of the potential malignant transformation of pre-malignant lesions. The aim of the present study was to investigate whether the expression of MAGE-A can be used to predict the malignant transformation of OLP. Paraffin-embedded tissue samples of OLP from 74 patients followed-up for at least 5 years were included. A total of 24 progressing and 50 non-progressing OLP, 18 corresponding tumor and 30 healthy mucosa specimens were analysed for MAGE-A 1, 3, 4, 6 10 and 12 expression by nested real‑time RT-PCR and graded for dysplasia. In total, 46% of the progressing lesions expressed at least 1 out of the examined MAGE-A antigens, whereas no expression was detected in any of the non-progressing OLP and normal specimens. The correlation between malignant transformation and MAGE-A expression was statistically significant (p=0.00001). Furthermore, 42% of the progressing OLPs without dysplasia (D0) expressed at least 1 antigen. The correlation between the grade of dysplasia and MAGE-A staining in the malignant transformation group was not significant (p=0.08). The detection of at least 1 MAGE-A antigen may allow the identification of high-risk lesions that may progress into carcinoma with time. Therefore, the investigation of MAGE-A expression should be assessed in order to obtain a more accurate evaluation of the potential cancer risk of OLP.

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