Goldmann T, Galle J, Wiedorn K H, Deutschbein M E, Neuhaus M, Branscheid D, Vollmer E
Department of Clinical and Experimental Pathology, Research Center Borstel, Germany.
Ann Diagn Pathol. 2001 Apr;5(2):84-90. doi: 10.1053/adpa.2001.23024.
We report two cases of patients suffering from multiple tumors in the lungs with questionable origin. In these cases, the expression of Surfactant-apoprotein-A (SP-A) by the tumor cells has been a helpful feature in the process of diagnosis by indicating primary carcinomas of the lungs. Surfactant-apoprotein-A is expressed by the pneumocytes II in lung tissue and a portion of non-small cell lung carcinomas and has not yet been found to be expressed by other tumors when detected immunohistochemically by use of the monoclonal antibody PE-10. We analyzed formalin-fixed, paraffin-embedded specimens of different malignancies with pulmonary location for the expression of SP-A by the use of PE-10 with other antibodies against additional epitopes such as the thyroid transcription factor-1. In normal lung areas a distinct staining of the pneumocytes II has been observed. All the control sections of primary and metastatic nonlung-carcinoma specimen in our study remained negative. The monoclonal antibody PE-10 used in this study provides high specificity when compared to the results obtained with polyclonal antibodies. One of the two cases reported, a mucinous carcinoma of the lungs, had been negative for thyroid transcription factor-1 but positive for SP-A. Thus, SP-A detected by immunohistochemistry using the monoclonal antibody PE-10, together with other parameters such as thyroid transcription factor-1, may be a useful tool for individual diagnosis of malignomas located in the lungs with a questionable primary origin. Ann Diagn Pathol 5:84-90, 2001.
我们报告了两例肺部存在多个来源不明肿瘤的患者。在这些病例中，肿瘤细胞表面活性蛋白A（SP-A）的表达在诊断过程中是一个有用的特征，提示为原发性肺癌。表面活性蛋白A由肺组织中的II型肺细胞以及部分非小细胞肺癌表达，当使用单克隆抗体PE-10进行免疫组织化学检测时，尚未发现其他肿瘤表达该蛋白。我们使用PE-10以及针对其他表位（如甲状腺转录因子-1）的抗体，分析了不同肺部恶性肿瘤的福尔马林固定、石蜡包埋标本中SP-A的表达情况。在正常肺组织区域观察到II型肺细胞有明显染色。我们研究中的所有原发性和转移性非肺癌标本的对照切片均为阴性。与多克隆抗体的结果相比，本研究中使用的单克隆抗体PE-10具有高特异性。报告的两例病例之一，肺黏液腺癌，甲状腺转录因子-1检测为阴性，但SP-A检测为阳性。因此，使用单克隆抗体PE-10通过免疫组织化学检测到的SP-A，与其他参数（如甲状腺转录因子-1）一起，可能是诊断原发性来源不明的肺部恶性肿瘤的有用工具。《诊断病理学杂志》5:84-90，2001年。
