Assessment of differentiation in adenocarcinoma cells from pleural effusion by peripheral airway cell markers and their diagnostic values.-猫眼课题宝

通过外周气道细胞标记物评估胸腔积液腺癌细胞的分化及其诊断价值。

DOI：

10.1016/s0169-5002(02)00302-1

发表时间：

2002

期刊：

Lung cancer

影响因子：

5.3

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

C. Takezawa;Hiroki Takahashi;T. Fujishima;M. Shiratori;Y. Morita;H. Sano;Y. Kuroki;S. Abe

超微结构研究表明，克拉拉细胞型腺癌比肺泡II型细胞型腺癌更常见，这两种类型的腺癌的预后都比其他类型的腺癌好，表明外周气道细胞分化的重要性。肺表面活性蛋白（SP）-A是肺泡II型细胞和Clara细胞的特异性标志物，而SP-C和Clara细胞10 kD蛋白（CC 10）可能分别对肺泡II型细胞和Clara细胞具有特异性和高度特异性。本研究的目的是通过评估这些细胞标志物的表达来评估胸腔积液中腺癌细胞的分化，并评估其作为判断胸腔积液原因的诊断工具的价值。我们检查了52例患者的胸腔积液; 20例原发性肺腺癌，6例小细胞肺癌，11例转移性恶性肿瘤和15例非肿瘤性疾病。对渗出液中的细胞团进行SP-A、proSP-C（SP-C的前体）和CC 10的免疫细胞化学染色。通过SP-A和proSP-C的免疫细胞化学研究，20例腺癌中分别有10例（50%）和6例（30%）在其渗出液细胞中显示阳性免疫反应性，而没有一例表达CC 10。因此，肺泡II型细胞可能是某些腺癌的主要祖细胞。在原发性肺腺癌患者的胸腔积液中，SP-A mRNA的逆转录-聚合酶链反应（RT-PCR）显示敏感性为83%，而在所有其余患者中，这些测定均为阴性。总之，我们表明，肺腺癌，这是部分分化为肺泡II型细胞，并不罕见，因为以前认为，RT-PCR和免疫细胞化学分析SP-A和pro-SP-C可能是值得的指标的鉴别诊断。

Ultrastructural studies have shown that Clara cell-type is a more common type of adenocarcinoma than alveolar type II cell-type, and that both types may provide better prognosis than other types, indicating an importance of differentiation toward peripheral airway cells. Pulmonary surfactant protein (SP)-A is a specific marker for both alveolar type II cells and Clara cells in peripheral lung tissues, while SP-C and Clara cell 10 kD protein (CC10) may be particularly and highly specific to alveolar type II cells and Clara cells, respectively. The aims of this study were to assess the differentiation of adenocarcinoma cells in pleural effusions by evaluating the expression of these cell markers and to evaluate their values as diagnostic tools for judging the cause of pleural effusion. We examined pleural effusions from 52 patients; 20 with primary lung adenocarcinomas, 6 with small cell lung carcinomas, 11 with metastatic malignant tumors and 15 with non-neoplastic diseases. The cell pellets from effusions were subjected to immunocytochemical staining for SP-A, proSP-C, a precursor of SP-C, and CC10. By this immunocytochemical study for SP-A and proSP-C, 10 (50%) and 6 (30%) of 20 adenocarcinomas, respectively, showed a positive immunoreactivity in their effusion cells, while none of them expressed CC10. Alveolar type II cells therefore may be the main progenitor cells of some adenocarcinomas. In pleural effusions from patients with primary lung adenocarcinomas, reverse transcriptase-polymerase chain reaction (RT-PCR) for SP-A mRNA showed a sensitivity of 83%, while, in all remaining patients, these assays were negative. In conclusion, we demonstrated that lung adenocarcinomas, which are partially differentiated toward alveolar type II cells, are not as rare as previously thought, and that both the RT-PCR and immunocytochemical analyses for SP-A and pro-SP-C could be worthy indicators of differential diagnosis.