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Kim, Kim, Kwon, Chung, Suh, Koh, Ham, Nam, Um, Kwon, and Park: The Utility of MAGE Gene Detection in Bronchial Washing Fluid for Patients with Peripheral NSCLC
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(1): 15-21.

Published online: 31 January 2008

DOI: https://doi.org/10.4046/trd.2008.64.1.15

The Utility of MAGE Gene Detection in Bronchial Washing Fluid for Patients with Peripheral NSCLC

Suhyun Kim, M.D., Hojoong Kim, M.D., O Jung Kwon, M.D., Man Pyo Chung, M.D., Gee Young Suh, M.D., Won-Jung Koh, M.D., Cho Rom Ham, M.D., Hae Seong Nam, M.D., Sang-Won Um, M.D., Yong Soo Kwon, M.D., Sunghoon Park, M.D.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address for correspondence: Hojoong Kim, M.D. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea. Phone: 82-2-3410-3425, Fax: 82-2-3410-3849, hjk3425@skku.edu

Received 11 December 2007       Accepted 11 January 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

The melanoma antigen-encoding (MAGE) genes are known to be expressed in various cancer cells, including non-small cell lung cancer (NSCLC), and are silent in all normal tissues except for the testis. In patients with peripheral NSCLC, bronchial washing fluid can be used to detect the MAGE genes, suggesting a diagnosis of lung cancer. In order to evaluate the diagnostic utility of the MAGE test in patients with peripheral NSCLC, bronchial washing fluid was investigated in patients with peripheral pulmonary nodules, which were invisible as detected by bronchoscopy.

Methods

Bronchial washing fluid from 37 patients was used for cytological examinations and MAGE gene detection, using RT-nested-PCR of common A1-A6 mRNA. Results were compared to a final diagnosis of patients as confirmed by pathology.

Results

Among the 37 subjects, NSCLC was diagnosed in 21 patients, and benign pulmonary diseases were diagnosed in 16 patients. MAGE mRNA was detected in 10 of 21 (47.6%) NSCLC patients, while conventional cytology examinations were positive for MAGE expression in 2 of 21 (9.5%) cases. MAGE expression was observed in 4 of 16 (25%) benign pulmonary disease patients.

Conclusion

The MAGE test of bronchial washing fluid can be used as a sensitive predictor of peripheral NSCLC patients.

Keywords: Melanoma antigen gene (MAGE), Lung neoplasm, Coin lesion

Figures and Tables

Figure 1
Amplification of MAGE 1-6 by nested RT-PCR using common MAGE primers. Lane 1: Negative control, Lane 2: Tumor tissue, Lane 3: Prostate cancer cell line, Lane 4: Somatic cancer cell line, Lane 5: MAGE positive control, Lane 6: Sample 1, Lane 7: Sample 2, Lane 8: Normal tissue. GAPDH: glyceraldehydes phosphate dehydrogenase.
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Table 1
Characteristics of patients
trd-64-15-i001

*Non-small cell lung cancer.

Table 2
Expression rate of MAGI Al-A6 RT-nested PCR in bronchial washing fluid according to histological types
trd-64-15-i002

*Non-small cell lung cancer.

Table 3
Expression rates of MAGE Al-A6 RT-nested PCR and cytology according to the pathologic stages in NSCLC patients
trd-64-15-i003
Table 4
Expression rate of MAGE Al-A6 RT-nested PCR in bronchial washing fluid with benign lung disease
trd-64-15-i004

*pulmonary arteriovenous malformation, †non-tuberculous mycobacterium.

Table 5
Sensitivity and specificity of MAGE and cytological examinations
trd-64-15-i005

*non-small cell lung cancer, †positive predictive value, ‡NPV: negative predictive value.

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