Journal List > Tuberc Respir Dis > v.69(6) > 1001567

Lee, Yun, Lee, Oh, Song, Sohn, Kim, Han, Kim, and Kim: The Clinical Implication of MAGE Gene Detection in Bronchial Washing Fluid in Routine Practice

Abstract

Background

Melanoma antigen genes (MAGE) are expressed in many human malignant cells and are silent in normal tissues other than in testis and in placenta. But MAGE expression in benign lung diseases, such as pulmonary tuberculosis or cases with severe inflammation, needs further evaluation to overcome false-positive findings. We evaluated detection rates of the melanoma antigen genes (MAGE) RT-nested PCR in bronchoscopic washing samples from patients with benign lung disease, as well as in patients with malignancies.

Methods

Bronchial washing fluid from 122 patients was used for cytological examination and MAGE gene detection using RT-nested-PCR of common A1-6 mRNA. We compared the results from the RT-nested PCR and the pathologic or bacteriologic diagnosis. We also analyzed the expression rate and false positive rate of MAGE gene.

Results

Among 122 subjects, lung cancer was diagnosed in 23 patients and benign lung disease was diagnosed in 99 patients. In patients with lung cancer, the positive rate of MAGE expression was 47.8% (11/23) and in benign lung disease group, the expression rate was 14.1% (14/99). Among benign lung disease group, the expression rate of MAGE gene (25.0%) in patients with pulmonary tuberculosis (11/44) was especially high.

Conclusion

MAGE A1-6 RT-nested PCR of bronchial washing fluid can be used as a complementary method in lung cancer, but that test results in a high false positive rate in tuberculosis patients.

Figures and Tables

Figure 1
Amplification of MAGE A1-6 genes and GAPDH gene from patients with Anthracotic nodule (1), NTM lung disease (2), Adenocarcinoma (3), Pneumonia, MRSA (4), Aspergilloma (5), Pulmonary TB (6), Benign tumor (7) and BOOP (8). MAGE gene were amplified by RT-nested PCR, and GAPD gene by RT-PCR. M: size marker; P: positive control; N: negative control; MAGE: melanoma antigen genes; GAPDH: glyceraldehydes phosphate dehydrogenase.
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Table 1
Characteristics of patients
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Table 2
Expression rate of MAGE Al-A6 RT-nested PCR in bronchial washing fluid according to histologic types
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MAGE: melanoma antigen genes; RT-nested PCR: reverse transcriptase- nested polymerase chain reaction; NSCLC: non-small cell lung cancer; BALToma: bronchus-associated lymphoid tissue lymphoma.

Table 3
Expression rate of MAGE Al-A6 RT-nested PCR in bronchial washing fluid with benign lung disease
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MAGE: melanoma antigen genes; RT-nested PCR: reverse transcriptase- nested polymerase chain reaction; NTM: non-tuberculous mycobacterium; ILD: interstitial lung disease.

Table 4
Patient characteristics with positive expression of MAGE A1-6 RT-nested PCR within the benign group
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MAGE: melanoma antigen genes; RT-nested PCR: reverse transcriptase-nested polymerase chain reaction; BWF: bronchial washing fluid; EBTB: endobronchial tuberculosis; py: pack-years of cigarette; TDL: tuberculosis-destroyed lung; DM: diabetes mellitus; CVA: cerebrovascular; COPD: chronic obstructive pulmonary disease; HTN: hypertension; MRSA: methicillin resistant staphylococcus aureus.

Table 5
Expression Rate of MAGE and cytologic examinations
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MAGE: melanoma antigen genes.

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