Background: In the last decades, survival rates in head and neck squamous
cell carcinoma (HNSCC) have not changed, with a five-year survival of only 50%. Thus,
there is a great need for the identification of new molecular targets and development of
novel therapeutic strategies. Cancer-testis antigens (CTAs) are expressed in various
types of tumor but rarely in healthy normal tissues. Therefore, they appear as ideal
targets for immunotherapy approaches, as well as, unique markers for cancer
Objective: This study evaluated the expression pattern of cancer/testis antigens (CTA)
in HNSCC samples and correlated the expression data with the clinicopathological
Methods: An in silico screening was performed using all CTA genes cataloged on the
CTDatabase and the expression of the eight CTA genes (ARMC3, DDX53, FTHL17,
GAGE1, MAGEA11, SYCE1, TCP11, and XAGE1) was examined in 89 HNSCC and 20
normal mucosa samples using RT-PCR analysis.
Results: GAGE1 (48.3%), XAGE1 (40.4%) and MAGEA11 (19.1%) were frequently and
specifically expressed in HNSCC samples and 68.5% of the cases expressed at least
one of these antigens. Moreover, GAGE1 and XAGE1 mRNA positivity was significantly
associated with the presence of metastasis in the lymph nodes (p=0.038 and p=0.023,
respectively) and, by multivariate analysis, male gender (p=0.032), advanced clinical
stage (p=0.018) and mRNA positivity for GAGE1 (p=0.010) were independent prognostic
factors for overall survival.
Conclusion: These findings suggest GAGE1 and XAGE1 expressions to be useful as
prognostic markers for HNSCC.