摘要
背景与目的间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因的产生对肺癌的发生、发展起重要作用。ALK酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)对ALK阳性肺癌患者具有较好的疗效。提高ALK阳性病例的检出率对患者有重要意义。本研究旨在探讨ALK阳性病例的临床病理特征、免疫组化(immunohistochemistry,IHC)方法在筛查ALK阳性病例中的意义,以及荧光原位杂交(fluorescence in situ hybridization,FISH)在检测流程中的作用。方法应用IHC方法检测525例肺癌患者组织标本中ALK的表达,并对其中34例进行FISH验证。结果肺癌病例中ALK IHC阳性率为5.14%(27/525)。ALK阳性组中年轻患者、女性患者比例高于ALK阴性组(P<0.05);实体型肺腺癌在ALK阳性组中比例明显增高,而腺泡型与贴壁型比例明显降低,与阴性组相比有差异(P<0.05)。34例病例进行FISH验证,IHC与FISH符合率随IHC阳性程度的增加递增。伴或不伴有EGFR突变的ALK IHC阳性病例,都必须进行ALK FISH验证。结论 IHC可以作为可靠的ALK筛查手段,提高ALK的检出率。FISH检测对确诊ALK阳性肺癌具有重要意义。
Background and objective The fusion （rearrangement） ofanaplasticlymphomakinase （ALK）genehas been identified as an import factor to the tumorigenesis and development of lung cancer. ALK tyrosine kinase inhibitors （ALKTKIs） have been proved to have good effects to ALK positive lung cancers, 1he increasement of the relevance ratio of ALK will be very important to patients. The aim of this study is to investigate the clinical pathological features of ALK positive lung cancer, and the roles ofimmunohistochemistry （IHC） and fluorescence in situ hybridization （FISH） in screening and confirming the ALK positive cases in the testing flow of ALK. Methods IHC analysis of ALK in tumor specimens was performed on 525 lung cancer patients. 34 cases among them were confirmed by FISH. Results The positive incidence of ALK by IHC was 5.14% （27/525）. The ALK positive patients were significantly younger than ALK negative patients （P〈O.05）, and femal was predominant （P〈0.05）. The proportion of solid predominant adenocarcinoma was significantly higher in ALK positive patients （P〈0.05）. While acinar and lepidic predominant adenocarcinoma were significantly lower in ALK positive patients （P〈0.05）. FISH was applied in 34 cases. The coincidence rate was increased with the increasement of positive intensity of IHC staining. All the IHC positive cases with or without EGFR mutation must be confirmed by FISH. Conclusion IHC is a reliable detection method to screening the ALK in lung cancer, and then enhance the relevance ration. To make a definite diagnosis of ALK positive lung cancer, FISH is a significant detection method.
出处
《中国肺癌杂志》
CAS
北大核心
2014年第3期226-232,共7页
Chinese Journal of Lung Cancer
关键词
肺肿瘤
ALK
EGFR
免疫组化
FISH
Lung neoplasms
Anaplastic lymphoma kinase gene （ALK）
Epidermal growth factor receptor （EGFR）
Immunohistochemistry （IHC）
Fluorescence in situ hybridization （FISH）
