膵腫瘍組織における腫瘍マーカー(CEA, TPA, CA19-9, POA,フェリチン)と膵逸脱酵素(Amylase, Elastase 1)の免疫組織化学的検討

The distribution of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), carbohydrate antigen 19-9 (CA19-9), pancreatic oncofetal antigen (POA), Ferritin, Amylase and Elastase 1 was studied immunohistochemically using an immunoperoxidase method in 26 conventional histopathologic sections of pancreatic tumor. CEA and CA19-9 were regarded as markers secreted into the glandular lumina from cancer cells, but TPA and POA were not. The expression of these markers was different from one case to another and had no fixed pattern in cases of pancreatic cancer. The degree of CEA staining correlated positively with that of TPA. CEA, TPA and CA19-9 were demonstrated on the luminal border, cytoplasma and marginal region of cancer cells in various degrees, but POA was only found in the cytoplasma of cancer cells. CEA, TPA and CA19-9 tended to be stained more strongly as the pancreatic cancer was more highly differentiated. The specimens were more frequently stained with CEA and TPA than with CA19-9. In two cases, CA19-9 was not expressed in tumor specimens, although serum levels of this marker were abnormally elevated. In these cases CA19-9 in normal epithelium of the pancreatic duct and choledochus may have leaked into the blood stream. The same process was considered in one case each of TPA and POA expression. TPA, Ferritin and Elastase 1 were expressed in two cases of islet cell tumor, while none of them was expressed in one case of apudoma. Elastase 1 was stained intensively on tumor cells in one case of pancreatic cancer and one case of islet cell tumor.