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Kim, Choi, and Shin: MAGE Gene Expression in Bronchial Washing Fluid in Suspected Parenchymal Lung Cancer
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(2): 156-162.

Published online: 29 February 2012

DOI: https://doi.org/10.4046/trd.2012.72.2.156

MAGE Gene Expression in Bronchial Washing Fluid in Suspected Parenchymal Lung Cancer

Kyu Jin Kim, M.D.1, 2, Eun Young Choi, M.D.1, 2, Kyeong-Cheol Shin, M.D., Ph.D.1, 2

1Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.

2Regional Center for Respiratory Disease, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.

Address for correspondence: Kyeong-Cheol Shin, M.D., Ph.D. Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyeong 5-dong, Nam-gu, Daegu 705-717, Korea. Phone: 82-53-620-3850, Fax: 82-53-654-8386, shin1014@ynu.ac.kr

Received 29 October 2011       Revised 28 November 2011       Accepted 9 January 2012

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

The main goal of this study was to evaluate the diagnostic efficacy of reverse transcription-nested polymerase chain reaction (RT-nested PCR) in bronchial washing fluid with MAGE A1-6 common primers for the detection of lung cancers invisible by bronchoscopy.

Methods

To determine the expression of MAGE A1-6 gene in 189 lung cancers diagnosed by conventional fluoroscopy-guided lung biopsy and 89 cancer-free controls, RT-nested PCR was performed in bronchial washing specimens. We analyzed MAGE A1-6 RT-nested PCR data according to tumor histology, stage, size, and compared them with cytological data.

Results

189 patients (111 cases in adenocarcinoma, 47 cases in squamous cell carcinoma, 22 cases in small cell lung carcinoma, and 9 cases in other cancers) and 89 benign patients were investigated. The expression of MAGE was performed by nested RT-PCR using common MAGE primer. Among 189 cancer patients, the expression rate of MAGE was 49.2%, and the positive predictive value was 89.4%. However, the expression rate of MAGE in patients with benign lesions was 12.4%. In peripheral lung cancer, the positive rate of MAGE expression was 57.4% in squamous cell carcinoma, 44.1% in adenocarcinoma and 59.1% in small cell lung cancer. Whereas the expression rate of bronchial washing cytology in peripheral lung cancer was 9.0% (p=0.011).

Conclusion

MAGE RT-PCR in bronchial washing fluid gave us promising data for the detection of peripheral lung cancer. It could be a useful method for selecting diagnostic tools for peripheral lesions.

Keywords: Lung Neoplasms, Early Detection of Cancer, Melanoma-Specific Antigens, Reverse Transcriptase Polymerase Chain Reaction

Figures and Tables

Table 1
Demographics in cancer and benign lung disease
trd-72-156-i001

*Others: Metastatic hepatocarcinoma, spindle cell carcinoma, neuroendocrine carcinoma, sarcomatoid carcinoma, mucoepidermoid carcinoma, lymphoma. †Others: anthracosis, leiomyoma and pulmonary eosinophilia.

Table 2
Overall diagnostic value and comparison of the conventional cytology and MAGE RT-nested PCR
trd-72-156-i002

*p=0.011.

RT-nested PCR: reverse transcription-nested polymerase chain reaction; PPV: positive predicted value; NPV: negative predicted value.

Table 3
Expression rate of MAGE in bronchial washing according to the histological types in lung cancer
trd-72-156-i003

*p>0.05 according to the histological types. †Others: Metastatic hepatocarcinoma, spindle cell carcinoma, neuroendocrine carcinoma, sarcomatoid carcinoma, mucoepidermoid carcinoma, lymphoma.

Table 4
Expression rate of MAGE in bronchial washing according to the tumor size in lung cancer
trd-72-156-i004

*p>0.05.

Table 5
Expression rate of MAGE in bronchial washing according to the location in lung cancer
trd-72-156-i005

*p>0.05.

Table 6
Expression rate of MAGE in benign lung disease
trd-72-156-i006

*Others: anthracosis, leiomyoma and pulmonary eosinophilia.

Acknowledgements

This research was supported by a grant of Yeungnam University Medical Center (2004).

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