Objectives As the best characterised cancer/testis antigen family members, melanoma-associated antigens (MAGE) have been reported to be expressed in various malignant tumours. However, the expression pattern of MAGE-A family in lung adenocarcinoma (LAC) specimens and their prognostic and therapeutic significance for patients with LAC is still unclear.

Materials and methods Tissue microarray-based immunohistochemistry analysis was used to examine the expression of MAGE-A family members (including MAGE-A1, A2, A3, A4, A6, A10, A11 and A12) in 105 paired LAC specimens and the corresponding pericarcinoma specimens. The association between MAGE-A expression and the clinicopathological parameters, and the 10-year overall survival of patients with LAC were analysed. In addition, the association between MAGE-A expression and the epithelial growth factor receptor (EGFR) amplification and ALK-EML4 rearrangements of patients with LAC were also analysed.

Results The immunohistochemical evaluation revealed that MAGE-A family was expressed in 46.66% of LAC specimens, but not in the corresponding pericarcinoma specimens. MAGE-A expression was not associated with the clinicopathological factors but with worse 10-year survival, and was a poor prognostic marker for patients with LAC. MAGE-A expression was not correlated with EGFR amplification and ALK rearrangements. Interestingly, MAGE-A expression can affect the overall survival of patients with LAC without EGFR amplification or ALK rearrangements, but not affect the overall survival of patients with LAC and EGFR amplification or ALK rearrangements.

Conclusions Molecular assessment of MAGE-A family members could be considered to improve the prognostic evaluation and to provide a new potential therapeutic strategy for patients with LAC.