Abstract:

Objective

To investigate the relationship between serum melanoma antigen A3（MAGEA3） and the diagnosis and prognosis of resectable lung adenocarcinoma.

Methods

All of 119 patients with resectable lung adenocarcinoma admitted to our hospital from March 2019 to April 2023 were selected as the observation group，and 55 patients with benign lung disease were selected as the control group. The expression level of serum MAGEA mRNA was detected by real-time quantitative polymerase chain reaction（rtPCR）. Serum MAGEA3 and MAGEA4 levels were detected by enzyme-linked immunosorbent assay. The diagnostic value of serum MAGEA3 was determined by receiver operator characteristic （ROC） curve. Follow-up up to December 2024，recurrence-free survival time was recorded.

Results

Serum MAGEA3 mRNA （2.03±0.45） and MAGEA4 mRNA （1.49±0.25） in the observation group were higher than those in the control group（1.01±0.21），（0.98±0.16）.There was significant difference （P＜0.05）. There was no significant difference in MAGEA1 mRNA，MAGEA2 mRNA and MAGEA6 mRNA between the two groups （P＞0.05）. Serum MAGEA3 level in the observation group was 48.33 （40.25，60.89） pg/ml and 34.20 （22.35，44.25） pg/ml in the control group （P＜0.05）. Multivariate Logistic regression analysis showed that serum MAGEA3 was a risk factor for lung adenocarcinoma （OR=2.112，95%CI： 1.552～2.873，P＜0.05）. ROC curve analysis showed that the area under the curve （AUC） of serum MAGEA3 for diagnosis of lung adenocarcinoma was 0.762，which was higher than the AUC 0.623 for carcinoembryonic antigen（CEA） and the AUC 0.613 for cytokeratin fragment 19 antigen 21-1（CYFRA211）. The AUC of the diagnosis of MAGEA3+CEA+neuron-specific enolase（NSE）+CYFRA211 was 0.865，the sensitivity and specificity were 84.87% and 76.36%，respectively. The high expression of MAGEA3 （≥37.71 pg/ml） was ≥60 years old，and the proportion of clinical stage T2-4 and TNM stage Ⅱ～Ⅲwas higher （P＜0.05）. The median follow-up period was 24.30 months （0.5-58.30 months），57 cases （47.90%） recurred，including 39 cases of local/regional recurrence and 18 cases of distant metastasis. The median serum MAGEA3 level of 55.97 pg/ml in relapsed patients was higher than 42.29 pg/ml in non-relapsed patients （Z=-4.423，P=0.000）. Kaplan-Meier curve analysis showed that the median survival time of relapse-free patients with serum MAGEA3≤48.33 pg/ml was 44.10 months，which was higher than that of patients with serum MAGEA3＞48.33 pg/ml 28.30 months （P=0.006）. The recurrence rate was 25.00%（15/60） in patients with serum MAGEA3 ≤48.33 pg/ml，and 71.19% （42/59） in patients with serum MAGEA3＞48.33 pg/ml.

Conclusion

Serum MAGEA3 level combined with traditional serum tumor markers can improve the diagnostic efficiency of lung adenocarcinoma patients，and its high level is associated with poor prognosis of patients.

Key words: Melanoma antigen family A member 3, Lung adenocarcinoma, Traditional tumor markers, Prognosis