, Volume 45, Issue 1, pp 407-429

Cytokeratins in normal lung and lung carcinomas

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The various epithelial cells of the lower respiratory tract and the carcinomas derived from them differ markedly in their differentiation characteristics. Using immunofluorescence microscopy and two-dimensional gel electrophoresis of cytoskeletal proteins from microdissected tissues we have considered whether cytokeratin polypeptides can serve as markers of cell differentiation in epithelia from various parts of the human and bovine lower respiratory tract. In addition, we have compared these protein patterns with those found in the two commonest types of human lung carcinoma and in several cultured lung carcinoma cell lines. By immunofluorescence microscopy, broad spectrum antibodies to cytokeratins stain all epithelial cells of the respiratory tract, including basal, ciliated, goblet, and alveolar cells as well as all tumor cells of adenocarcinomas and squamous cell carcinomas. However, in contrast, selective cytokeratin antibodies reveal cell type-related differences. Basal cells of the bronchial epithelium react with antibodies raised against a specific epidermal keratin polypeptide but not with antibodies derived from cytokeratins characteristic of simple epithelia. When examined by two-dimensional gel electrophoresis, the alveolar cells of human lung show cytokeratin polypeptides typical of simple epithelia (nos. 7, 8, 18 and 19) whereas the bronchial epithelium expresses, in addition, basic cytokeratins (no. 5, small amounts of no. 6) as well as the acidic polypeptides nos. 15 and 17. Bovine alveolar cells also differ from cells of the tracheal epithelium by the absence of a basic cytokeratin polypeptide. All adenocarcinomas of the lung reveal a “simple-epithelium-type” cytokeratin pattern (nos. 7, 8, 18 and 19). In contrast, squamous cell carcinomas of the lung contain an unusual complexity of cytokeratins. We have consistently found polypeptides nos. 5, 6, 8, 13, 17, 18 and 19 and, in some cases, variable amounts of cytokeratins nos. 4, 14 and 15.

Several established cell lines derived from human lung carcinomas (SK-LU-1, Calu-1, SK-MES-1 and A-549) show a uniform pattern of cytokeratin polypeptides (nos. 7, 8, 18 and 19), similar to that found in adenocarcinomas. In addition, vimentin filaments are produced in all the cell lines examined, except for SK-LU-1.

From these analyses we conclude, in contrast to some previous reports, (1) that all epithelial cells from the trachea and lung contain cytokeratins, (2) that epithelial cells from different parts of the respiratory tract express different cytokeratins, and (3) that the bronchial epithelium is characterized by the occurrence of basic (nos. 5 and 6) and acidic (nos. 15 and 17) polypeptides which are absent from alveoli. A marked, probably related difference in cytokeratin expression is also seen between squamous cell carcinomas and adenocarcinomas.

The possible value of analyses of cytokeratin polypeptide patterns in lung carcinomas and metastases is discussed in relation to the diagnosis and histogenesis of lung neoplasms. We propose to use monoclonal antibodies specific for individual cytokeratin polypeptides as selective diagnostic tools for the differentiation and classification of lung carcinomas.