MAGE-A expression in oral and laryngeal leukoplakia predicts malignant transformation

Baran C, Agaimy A, Wehrhan F, Weber M, Hille V, Brunner K, Wickenhauser C, Siebolts U, Nkenke E, Kesting MR, Ries J (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Modern Pathology Nature Publishing Group: Open Access Hybrid Model Option B

Book Volume: 32

Pages Range: 1068-1081

Journal Issue: 8

DOI: 10.1038/s41379-019-0253-5

Abstract

Leukoplakia is a potential precursor of oral as well as laryngeal squamous cell carcinoma. Risk assessment of malignant transformation based on the grade of dysplasia of leukoplakia often does not lead to reliable results. However, oral squamous cell carcinoma, laryngeal squamous cell carcinoma, and leukoplakia express single or multiple members of the melanoma-associated antigens A (MAGE-A) family, while MAGE-A are absent in healthy mucosal tissue. The present study aimed at determining if there is an association between the expression of MAGE-A in leukoplakia and malignant transformation to oral or laryngeal squamous cell carcinoma. Paraffin-embedded tissues of 205 oral and laryngeal leukoplakia, 90 corresponding tumors, and 40 healthy oral mucosal samples were included in the study. The grade of dysplasia of the leukoplakia samples was determined histopathologically. The leukoplakia samples were divided into lesions that transformed to oral and laryngeal squamous cell carcinoma (n = 91) and lesions that did not (n = 114) during a 5 years follow-up. The expression of MAGE-A3/6 and MAGE-A4 was analyzed by real-time RT-PCR. The expression of MAGE-A 1–4, 6, and 12 was determined by immunohistochemistry. A total of 59.3% of the transforming leukoplakia expressed at least one of the examined antigens as opposed to an expression rate of 3.5% of all non-transforming leukoplakia. There was no MAGE-A expression in healthy oral mucosa. The risk of malignant transformation was statistically significantly associated with MAGE-A expression in immunohistochemistry (p < 0.001) and real-time RT-PCR (MAGE-A3/6, p = 0.001; MAGE-A4, p = 0.002) analyses. There was no significant association between MAGE-A expression and the grade of dysplasia (“low-grade”, D0/D1; “high-grade”, D2/D3) in immunohistochemistry (p = 0.412) and real-time RT-PCR (MAGE-A3/6, p = 0.667; MAGE-A4, p = 0.756). It seems that the analysis of the MAGE-A expression profile may support the identification of leukoplakia at risk for malignant transformation. Therefore, efforts should be made to establish this analysis as a routine procedure in addition to conventional histopathology.

Authors with CRIS profile

Christoph Baran Department of Oral and Cranio-Maxillofacial Surgery Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Falk Wehrhan Department of Oral and Cranio-Maxillofacial Surgery Manuel Weber Department of Oral and Cranio-Maxillofacial Surgery Verena Hille Department of Oral and Cranio-Maxillofacial Surgery Marco Rainer Kesting Lehrstuhl für Zahnmedizin, insbesondere Mund-, Kiefer-, und Gesichtschirurgie Jutta Ries Medizinische Fakultät

Involved external institutions

Universitätsklinikum Halle (Saale) DE Germany (DE) Klinikum Weiden DE Germany (DE) Vienna General Hospital / Allgemeines Krankenhaus der Stadt Wien (AKH) AT Austria (AT)

How to cite

APA:

Baran, C., Agaimy, A., Wehrhan, F., Weber, M., Hille, V., Brunner, K.,... Ries, J. (2019). MAGE-A expression in oral and laryngeal leukoplakia predicts malignant transformation. Modern Pathology, 32(8), 1068-1081. https://doi.org/10.1038/s41379-019-0253-5

MLA:

Baran, Christoph, et al. "MAGE-A expression in oral and laryngeal leukoplakia predicts malignant transformation." Modern Pathology 32.8 (2019): 1068-1081.

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