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홍건식,김세민 고려대학교 의과대학 1989 고려대 의대 잡지 Vol.26 No.1
Carcinoembryonic antigen(CEA) and alpha-fetoprotein(AFP) have been well known as tumor associated antigens. Recently, with the development of immunology much of the effort has been directed towards measurement of serum and tissue levels of these tumor markers in various organs. However, the more recent attention has been focussed on the exploitation of tumor markers for immunohistochemical PAP study by using anti-CEA and anti-AFP monoclonal antibodies. The author performed peroxidase-antiperoxidase immunohistochemical study with anti-CEA antibody and anti-AFP antibody (Bio Genex Laboratories) to determine the presence of CEA and AFP in the 33 cases of various pancreatic diseases. The findings were analysed and the results obtained are as follows. 1. In the infantile pancreatic normal tissue group; CEA positive reaction to anti-CEA antibody was noted in none of 4 cases (0%). AFP positive reaction to anti-AFP antibody showed weak positive(1+) in all of 4 case(100%). 2. In the non-inflammatory and non-neoplastic pancreatic disease group CEA positive reaction was noted in 1 of 4 cases(25%), which was weak positive(1+). However, there was no AFP positive reaction to anti-AFP antibody (0%). 3. In the chronic pancreatitis group; CEA positive reaction showed strong positive in all of 5 cases(100%). AFP positive reaction was noted in 2 of 5 cases(40%), which were weak positive(1+). 4. In the borderline malignancy group, CEA positive reaction was noted in 1 of 2 cases papillary cystic neoplasm(50%), which was weak positive(1+). There was no AFP positive reaction(0%). 5. Inthe pancreatic adenocarcinoma group; CEA positive reaction was noted in 10 of 12 cases(83.3%). The moderately to well differenciated carcinoma was strong positive and the poorly differenciated carcinoma was negative to weak positive. However, AFP positive reaction was noted in only 3 of 12 cases (25%), which were moderate to weak positive. 6. In the metastatic pancreatic cancer and other cancer group; CEA positive reaction was noted in 3 of 6 cases(50%), which were weak positive(1+) and metastatic malignant lymphoma was negative. AFP positive reaction was noted in 1 adeno-squamous carcinoma of 6 cases (17%). 7. The results obtained above suggest the following findings: a. Irritated ductal epithelium, altered either by inflammation or by neoplasm, appears to have positive CEA reaction. b. Non-irritated ductal epithelium appears to have negative CEA reaction. c. Pancreatic acinii in all cases appear to have negative CEA reaction. d. Uncertain or nonductal epithelial origin cancer appears to have weak positive CEA reaction. AFP may not be a useful market for the early diagnosis of pancreatic cancer, but for some patients with advanced cancer, and it can serve as a tumor marker to indicate the extent of disease. CEA and AFP seem to be useful indicators in the field of differential diagnosis of poorly differentiated or undifferentiated pancreatic cancer.
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