中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2014年
3期
226-232
,共7页
朱翔%李红威%曹宝山%柳晨%梁莉%王玉湘%由江峰%高菲%马晓龙%刘岩%王华%张燕%陈剑%张波
硃翔%李紅威%曹寶山%柳晨%樑莉%王玉湘%由江峰%高菲%馬曉龍%劉巖%王華%張燕%陳劍%張波
주상%리홍위%조보산%류신%량리%왕옥상%유강봉%고비%마효룡%류암%왕화%장연%진검%장파
肺肿瘤%ALK%EGFR%免疫组化%FISH
肺腫瘤%ALK%EGFR%免疫組化%FISH
폐종류%ALK%EGFR%면역조화%FISH
Lung neoplasms%Anaplastic lymphoma kinase gene (ALK)%Epidermal growth factor receptor (EGFR)%Immunohistochemistry (IHC)%Fluorescence in situ hybridization (FISH)
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（immuno-histochemistry, IHC）方法在筛查ALK阳性病例中的意义，以及荧光原位杂交（lfuorescence 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。
揹景與目的間變性淋巴瘤激酶（anaplastic lymphoma kinase, ALK）融閤基因的產生對肺癌的髮生、髮展起重要作用。ALK酪氨痠激酶抑製劑（tyrosine kinase inhibitors, TKIs）對ALK暘性肺癌患者具有較好的療效。提高ALK暘性病例的檢齣率對患者有重要意義。本研究旨在探討ALK暘性病例的臨床病理特徵、免疫組化（immuno-histochemistry, IHC）方法在篩查ALK暘性病例中的意義，以及熒光原位雜交（lfuorescence in situ hybridization, FISH）在檢測流程中的作用。方法應用IHC方法檢測525例肺癌患者組織標本中ALK的錶達，併對其中34例進行FISH驗證。結果肺癌病例中ALK IHC暘性率為5.14%（27/525）。ALK暘性組中年輕患者、女性患者比例高于ALK陰性組（P<0.05）；實體型肺腺癌在ALK暘性組中比例明顯增高，而腺泡型與貼壁型比例明顯降低，與陰性組相比有差異（P<0.05）。34例病例進行FISH驗證，IHC與FISH符閤率隨IHC暘性程度的增加遞增。伴或不伴有EGFR突變的ALK IHC暘性病例，都必鬚進行ALK FISH驗證。結論 IHC可以作為可靠的ALK篩查手段，提高ALK的檢齣率。FISH檢測對確診ALK暘性肺癌具有重要意義。
배경여목적간변성림파류격매（anaplastic lymphoma kinase, ALK）융합기인적산생대폐암적발생、발전기중요작용。ALK락안산격매억제제（tyrosine kinase inhibitors, TKIs）대ALK양성폐암환자구유교호적료효。제고ALK양성병례적검출솔대환자유중요의의。본연구지재탐토ALK양성병례적림상병리특정、면역조화（immuno-histochemistry, IHC）방법재사사ALK양성병례중적의의，이급형광원위잡교（lfuorescence in situ hybridization, FISH）재검측류정중적작용。방법응용IHC방법검측525례폐암환자조직표본중ALK적표체，병대기중34례진행FISH험증。결과폐암병례중ALK IHC양성솔위5.14%（27/525）。ALK양성조중년경환자、녀성환자비례고우ALK음성조（P<0.05）；실체형폐선암재ALK양성조중비례명현증고，이선포형여첩벽형비례명현강저，여음성조상비유차이（P<0.05）。34례병례진행FISH험증，IHC여FISH부합솔수IHC양성정도적증가체증。반혹불반유EGFR돌변적ALK IHC양성병례，도필수진행ALK FISH험증。결론 IHC가이작위가고적ALK사사수단，제고ALK적검출솔。FISH검측대학진ALK양성폐암구유중요의의。
Background and objective hTe fusion (rearrangement) of anaplastic lymphoma kinase (ALK) gene has been identiifed as an import factor to the tumorigenesis and development of lung cancer. ALK tyrosine kinase inhibitors (ALK-TKIs) have been proved to have good effects to ALK positive lung cancers. hTe increasement of the relevance ratio of ALK will be very important to patients. hTe aim of this study is to investigate the clinical pathological features of ALK positive lung cancer, and the roles of immunohistochemistry (IHC) and lfuorescence in situ hybridization (FISH) in screening and conifrm-ing the ALK positive cases in the testing lfow of ALK. Methods IHC analysis of ALK in tumor specimens was performed on 525 lung cancer patients. 34 cases among them were conifrmed by FISH. Results hTe positive incidence of ALK by IHC was 5.14%(27/525). hTe ALK positive patients were signiifcantly younger than ALK negative patients (P<0.05), and femal was predominant (P<0.05). hTe proportion of solid predominant adenocarcinoma was signiifcantly higher in ALK positive patients (P<0.05). While acinar and lepidic predominant adenocarcinoma were signiifcantly lower in ALK positive patients (P<0.05). FISH was applied in 34 cases. hTe 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 conifrmed by FISH. Conclusion IHC is a reliable detec-tion method to screening the ALK in lung cancer, and then enhance the relevance ration. To make a deifnite diagnosis of ALK positive lung cancer, FISH is a signiifcant detection method.
