Dowlati A, Loo M, Bury T, Fillet G, Beguin Y
Department of Internal Medicine, University of Liège, School of Medicine, Belgium.
Br J Cancer. 1997;75(12):1802-6. doi: 10.1038/bjc.1997.307.
The expression of transferrin receptor (TfR) has been identified in many malignant tumours. In lung cancer, lymphoma and breast cancer, it has been shown that the expression of TfR correlates with tumour differentiation, probably implying some prognostic value. A soluble form of TfR (sTfR) in human serum has been shown to be proportional to the number of cellular TfRs. Based on these data we examined the utility of measuring sTfR in the serum and bronchoalveolar lavage (BAL) fluid of patients with lung cancer (n = 32) and patients with chronic obstructive pulmonary disease (n = 22). BAL fluid was centrifuged to separate the supernatant from the cellular component. Cells were lysed in a detergent and cell-associated TfR was measured by enzyme-linked immunosorbent assay (ELISA) and expressed as ng 10(-6) cells in this cellular component. There was no difference in serum sTfR between the cancer and chronic obstructive pulmonary disease (COPD) groups. A higher level of cell-associated TfR was found in BAL of non-small-cell lung cancer patients than in COPD patients (P = 0.01). The calculated number of TfR molecules per cell in BAL correlated positively with the percentage of macrophages in BAL (P < 0.0001), suggesting that cell-associated TfR in BAL originates primarily from macrophages in this fluid. No correlation existed between BAL cell-associated TfR and tumour size, nodal status, the presence of metastases and serum sTfR. BAL cell-associated TfR was negatively correlated with BAL supernatant neuron-specific enolase (NSE) (P = 0.01). A combination of BAL supernatant NSE and cell-associated TfR detected lung cancer with a sensitivity of 91%, a specificity of 59% and positive and negative predictive values of 81% and 71% respectively. In conclusion, BAL cell-associated TfR may help in the differential diagnosis of lung cancer vs pneumonia.
转铁蛋白受体（TfR）的表达已在许多恶性肿瘤中得到证实。在肺癌、淋巴瘤和乳腺癌中，研究表明TfR的表达与肿瘤分化相关，这可能意味着其具有一定的预后价值。人血清中的可溶性TfR（sTfR）已被证明与细胞TfR的数量成正比。基于这些数据，我们检测了肺癌患者（n = 32）和慢性阻塞性肺疾病患者（n = 22）血清和支气管肺泡灌洗（BAL）液中sTfR检测的实用性。将BAL液离心以分离上清液和细胞成分。细胞用去污剂裂解，通过酶联免疫吸附测定（ELISA）测量细胞相关的TfR，并以该细胞成分中每10^(-6)个细胞中的纳克数表示。癌症组和慢性阻塞性肺疾病（COPD）组之间的血清sTfR没有差异。非小细胞肺癌患者BAL中的细胞相关TfR水平高于COPD患者（P = 0.01）。BAL中每细胞计算的TfR分子数与BAL中巨噬细胞的百分比呈正相关（P < 0.0001），这表明BAL中细胞相关的TfR主要来源于该液体中的巨噬细胞。BAL细胞相关TfR与肿瘤大小、淋巴结状态、转移的存在和血清sTfR之间没有相关性。BAL细胞相关TfR与BAL上清液神经元特异性烯醇化酶（NSE）呈负相关（P = 0.01）。BAL上清液NSE和细胞相关TfR联合检测肺癌的敏感性为91%，特异性为59%，阳性和阴性预测值分别为81%和71%。总之，BAL细胞相关TfR可能有助于肺癌与肺炎之间的鉴别诊断。
