선양낭성암종과 다형선종의 감별에서 MAGE A의 유용성

Abstract

Even though salivary gland tumors, pleomorphic adenoma(PA) and adenoid cystic carcinoma(ACC) are clinically different, the same histological patterns shared between them make diagnosis of specimens obtained from biopsy, partial excision, and even total excision of tumor difficult. Many researchers suggested useful markers for the differential diagnosis of the tumors, but most of them were turned out to be unpractical. Therefore, the study examined the utility of using MAGE as a diagnostic method in the differential diagnosis of PA and ACC. For 48 paraffin-embedded tissue specimens, who were diagnosed as PA(n=31) and ACC(n=17), immunohistochemical stains using MAGE A and MAGE-A4 were performed. Moreover, for the fresh frozen specimens of PA(n=3) and ACC(n=4), MAGE gene was extracted by real time RT-PCR to show the justification of performing immunohistochemical stains. In the immunohistochemical stain, the expression of MAGE A was not observed in 84% of the PA, on the other hand, the expression of that was observed in 100% of ACC. Expression of MAGE-A4 was not observed in 97% of the PA, but the expression of that was observed in 100% of ACC. In the real time RT-PCR, any MAGE gene was not expressed in PA, but MAGE-A3 and -A4 were expressed significantly in ACC. Therefore, the study suggests that the immunohistochemical stain using MAGE could be a useful diagnostic tool for the differential diagnosis of PA and ACC. ___________________________________________________________________ Key words : pleomorphic adenoma, adenoid cystic carcinoma, MAGE