中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2015年
9期
628-632
,共5页
陈颖%高丽丽%王彦丽%桂贤%张皓%王龙富%顾良宏%冯丽青%吴佳文%杨文韬%宋以菊%曾欢%张静%柏乾明%周晓燕%平波
陳穎%高麗麗%王彥麗%桂賢%張皓%王龍富%顧良宏%馮麗青%吳佳文%楊文韜%宋以菊%曾歡%張靜%柏乾明%週曉燕%平波
진영%고려려%왕언려%계현%장호%왕룡부%고량굉%풍려청%오가문%양문도%송이국%증환%장정%백건명%주효연%평파
肺肿瘤%腺癌%活组织检查,针吸%原位杂交,荧光%细胞诊断学
肺腫瘤%腺癌%活組織檢查,針吸%原位雜交,熒光%細胞診斷學
폐종류%선암%활조직검사,침흡%원위잡교,형광%세포진단학
Lung neoplasms%Adenocarcinoma%Biopsy,needle%In situ hybridization,fluorescence%Cytodiagnosis
目的探讨间变性淋巴瘤激酶（ ALK）基因重排阳性肺腺癌的细胞病理学特点。方法回顾性分析2011年9月至2015年4月在复旦大学附属肿瘤医院用细胞学标本进行ALK基因重排和／或ALK融合蛋白检测的肺腺癌连续病例153例，包括胸水34例，经气管镜超声引导针吸活检术（ EBUS-TBNA）40例，体表肿块穿刺79例。结果经荧光原位杂交（ FISH）和免疫组织化学Ventana ALK（D5F3）证实的ALK阳性病例共39例（25.5％），其中单独由FISH法确定的3例，经两者共同证实的36例。中位年龄50岁，较ALK阴性者（60岁）年轻（ P＝0.002）。39例ALK阳性患者中只有4例为吸烟者，明显少于阴性组（ P＜0.01）。 ALK阳性病例中3例可见筛孔状结构和明显的核仁，3例见筛孔状结构和黏液细胞，8例见细胞外黏液和黏液细胞，出现率显著高于ALK阴性病例（均P＜0.01）。结论细胞学标本（常规涂片和细胞块）可以显示ALK阳性肺腺癌的一些形态学特征如筛孔状结构、明显的核仁、黏液细胞和细胞外黏液等，结合患者临床特征，对于筛选潜在ALK阳性的肺腺癌患者有一定帮助。
目的探討間變性淋巴瘤激酶（ ALK）基因重排暘性肺腺癌的細胞病理學特點。方法迴顧性分析2011年9月至2015年4月在複旦大學附屬腫瘤醫院用細胞學標本進行ALK基因重排和／或ALK融閤蛋白檢測的肺腺癌連續病例153例，包括胸水34例，經氣管鏡超聲引導針吸活檢術（ EBUS-TBNA）40例，體錶腫塊穿刺79例。結果經熒光原位雜交（ FISH）和免疫組織化學Ventana ALK（D5F3）證實的ALK暘性病例共39例（25.5％），其中單獨由FISH法確定的3例，經兩者共同證實的36例。中位年齡50歲，較ALK陰性者（60歲）年輕（ P＝0.002）。39例ALK暘性患者中隻有4例為吸煙者，明顯少于陰性組（ P＜0.01）。 ALK暘性病例中3例可見篩孔狀結構和明顯的覈仁，3例見篩孔狀結構和黏液細胞，8例見細胞外黏液和黏液細胞，齣現率顯著高于ALK陰性病例（均P＜0.01）。結論細胞學標本（常規塗片和細胞塊）可以顯示ALK暘性肺腺癌的一些形態學特徵如篩孔狀結構、明顯的覈仁、黏液細胞和細胞外黏液等，結閤患者臨床特徵，對于篩選潛在ALK暘性的肺腺癌患者有一定幫助。
목적탐토간변성림파류격매（ ALK）기인중배양성폐선암적세포병이학특점。방법회고성분석2011년9월지2015년4월재복단대학부속종류의원용세포학표본진행ALK기인중배화／혹ALK융합단백검측적폐선암련속병례153례，포괄흉수34례，경기관경초성인도침흡활검술（ EBUS-TBNA）40례，체표종괴천자79례。결과경형광원위잡교（ FISH）화면역조직화학Ventana ALK（D5F3）증실적ALK양성병례공39례（25.5％），기중단독유FISH법학정적3례，경량자공동증실적36례。중위년령50세，교ALK음성자（60세）년경（ P＝0.002）。39례ALK양성환자중지유4례위흡연자，명현소우음성조（ P＜0.01）。 ALK양성병례중3례가견사공상결구화명현적핵인，3례견사공상결구화점액세포，8례견세포외점액화점액세포，출현솔현저고우ALK음성병례（균P＜0.01）。결론세포학표본（상규도편화세포괴）가이현시ALK양성폐선암적일사형태학특정여사공상결구、명현적핵인、점액세포화세포외점액등，결합환자림상특정，대우사선잠재ALK양성적폐선암환자유일정방조。
Objective To study the cytomorphologic features of anaplastic lymphoma kinase ( ALK )-rearranged pulmonary adenocarcinoma.Methods The morphologic features in 153 pulmonary adenocarcinoma cytology specimens encountered during the period from September, 2011 to April, 2015 in Shanghai Cancer Hospital were retrospectively reviewed.Fluorescence in-situ hybridization ( FISH) and/or immunohistochemistry ( Ventana D5F3) for ALK gene rearrangement were carried out.The samples studied included 34 pleural effusion specimens, 40 endobronchial ultrasound-guided transbronchial needle aspirates ( EBUS-TBNA) and 79 fine needle aspirates of palpable masses on body surface.Results Thirty-nine cases (25.5%) of ALK-rearranged samples were identified by FISH and/or immunohistochemistry, including 3 cases diagnosed by FISH and 36 cases by both technologies.The median age of the ALK-positive group was 50 years, significantly younger than that of the ALK-negative group (60 years old,P=0.002) .Only 4 of the ALK-positive patients were smokers, which was significantly less than that of the ALK-negative group (P<0.01).In ALK-positive group, 3 cases showed cribriform pattern with prominent nucleoli, 3 cases showed cribriform pattern with mucin-rich cells and 8 cases showed extracellular mucus with mucin-rich cells.The above cytomorphologic patterns were significantly less common in ALK-negative tumors ( P <0.01 ) . Conclusions ALK-rearranged lung adenocarcinoma is associated with certain distinctive morphologic patterns, including cribriform architecture, presence of prominent nucleoli, mucin-rich cells and extracellular mucus, which can be observed in cytology specimens ( including conventional smears and cell block sections) .These findings, when combined with clinical features, may give clues to detection of ALK-positive cases.
