Melanoma antigen genes A1 and A3 as predictors of treatment response and survival in HCV-associated hepatocellular carcinoma - a prospective study

Sep 22, 2026

Upload by Logic

Melanoma antigen gene expression was evaluated as a diagnostic and prognostic indicator in HCV-associated hepatocellular carcinoma. A prospective four-year case-control study enrolled 95 participants across three cohorts: HCC on HCV-induced cirrhosis, post-HCV cirrhosis, and healthy controls. qRT-PCR on PBMC-derived samples quantified MAGE-A1 and MAGE-A3, with patients followed for treatment response and overall survival over two years. MAGE-A1/A3 levels distinguished HCC from cirrhosis and were linked to shorter survival.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Introduction

Hepatocellular carcinoma background

MAGE gene family and expression

Subjects and methods

Study design and cohorts

qRT-PCR assessment

Results

Diagnostic discrimination

Treatment response association

Overall survival risk factors

Conclusion

Elgamal et al. BMCGastroenterology (2026) 26:68 [https://doi.org/10.1186/s12876-025-04574-8](https://doi.org/10.1186/s12876-025-04574-8) BMC Gastroenterology RESEARCH Open Access Melanoma antigen genes A1 and A3 as predictors of treatment response and survival in HCV-associated hepatocellular carcinoma: a prospective study Hoda Elgamal1, Dina Elhammady1, Salwa M. Abo El-Khair2, Adel El-Badrawy3, Amr Samir1*, Khaled Farid 1 and Hatem El Alfy1 Abstract Introduction Hepatocellular carcinoma (HCC) accounts for approximately 90% of all primary liver cancers resulting in approximately 830,000 deaths in 2020, making HCC the sixth most common cancer globally. Several members of the Melanoma Antigen Gene (MAGE) family, such as MAGE-A1 and A3 genes of the MAGE I-A subfamily, are abnormally expressed in a variety of cancers including melanomas, colorectal cancer, non-small cell lung cancer, gliomas, HCC, prostate, and breast cancers. In addition, they have been linked to tumor stemness and, therefore, may predict therapeutic response and prognosis. Aim of the study To investigate the expression pattern of MAGE-A1 and A3 genes in HCC patients and to evaluate their prognostic value. Subjects and methods This prospective four-year case-control study was conducted from 2020 to 2024 on 95 subjects classified into three groups. Group (A): Fifty patients with HCC developed on top of hepatitis C virus (HCV) -induced liver cirrhosis, Group (B): 30 patients with post-HCV liver cirrhosis and Group (C): 15 healthy control subjects. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to evaluate the expression of MAGE-A1 and A3 genes in peripheral blood sample after peripheral blood mononuclear cells (PBMCs) isolation. Patients were followed up over 2 years duration for assessment of treatment response. Results At cutoff levels 11.54 and 11.39 MAGE-A1 and MAGE-A3, respectively, could distinguish HCC from liver cirrhosis with area under the curve (AUC) of 0.781 and 0 . 966, respectively (P ≤0. 001) . Regarding treatment response, MAGE-A1 and A3 showed significantly higher expression in patients with progressive disease (16 .16 and 17. 79, respectively) compared to complete response patients (9 .21 and 13. 25, respectively) . Finally, when assessing overall survival (OS) in HCC patients multivariate analysis showed that independent factors for shorter OS were increased MAGE-A1 (HR: 9 .407, P: 0 . 048), high MAGE-A3 (HR: 9 . 199, P: 0 . 042) and elevation of both alpha fetoprotein (AFP) and MAGE-A3 (HR: 10. 681, P: 0 . 039) . *Correspondence: Amr Samir [dramrsamir@mans.edu.eg](dramrsamir@mans.edu.eg) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Elgamal et al. BMC Gastroenterology (2026) 26:68 Page 2 of 10 Conclusion MAGE-A1 and A3 genes can be used as diagnostic and prognostic markers in HCC patients predicting therapeutic response and overall survival. Keywords HCC, MAGE genes Introduction Hepatocellular carcinoma (HCC) acc

FAQs

What was the study aim regarding MAGE-A1 and MAGE-A3?

To determine the expression pattern of MAGE-A1 and A3 in HCC patients and assess their prognostic value for treatment response and survival.

How were MAGE-A1 and MAGE-A3 measured in the study?

Quantitative real-time PCR (qRT-PCR) quantified MAGE-A1 and MAGE-A3 expression in peripheral blood samples after PBMC isolation.

What did the results show about diagnostic ability?

Using cutoff values, MAGE-A1 and MAGE-A3 distinguished HCC from liver cirrhosis with AUC values of about 0.781 and 0.966, respectively.

Which factors were associated with shorter overall survival?

Multivariate analysis indicated increased MAGE-A1 and high MAGE-A3, and an elevation of both AFP and MAGE-A3 were independent factors for shorter OS.

Sep 22, 2026

Upload by Logic