检测肺腺癌活检标本间变性淋巴瘤激酶蛋白表达和基因融合  

ALK protein expression and gene fusion in bronchoscopic specimens of lung adenocarcinoma

作　　者：梁小龙[1] 王孟昭[2] 张静[1] 罗玉凤[1] 张淑英[1] 武莎斐[1] 刘媛媛[1] 曾瑄[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院病理科,100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸科,100730

出　　处：《中华肿瘤杂志》2014年第7期501-504,共4页Chinese Journal of Oncology

基　　金：北京市科委科技计划重大项目（D141100000214003）

摘　　要：目的 探讨采用肺腺癌支气管镜活检标本检测间变性淋巴瘤激酶（ALK）蛋白表达和基因融合的可行性,及其与临床病理特征的关系.方法 74例福尔马林固定石蜡包埋的肺腺癌支气管镜活检标本,采用Bench Mark全自动免疫组化染色机和D5F3抗体试剂盒,以免疫组化法检测ALK蛋白的表达,采用Abbott ALK分离探针,以荧光原位杂交（FISH）法检测ALK基因融合.结果 74例标本中,65例成功地进行了FISH检测,成功检测率为87.8％ （65/74）;FISH阳性5例,阳性率为7.7％（5/65）,均为中晚期低分化腺癌;其中免疫组化阳性3例,阳性率为4.1％ （3/74）;另2例为免疫组化阴性.其余69例标本免疫组化均阴性,其中包括9例FISH无信息的标本（7例癌细胞数＜50个,2例FISH信号弱无法判读）.ALK蛋白表达和基因融合与患者的性别、年龄、吸烟史、组织类型、分化程度和淋巴结转移均无关.结论 肺腺癌支气管镜活检标本可用以检测ALK蛋白表达和基因融合.免疫组化和FISH两种方法结合,可能更利于ALK阳性患者的检出.Objective To explore ALK protein expression and gene fusion in formalin-fixed and paraffin-embedded （FFPE） specimens obtained from lung cancer by bronchoscopy,and to investigate the relationship between ALK status and clinicopathological characteristics of the patients.Methods Seventyfour FFPE samples obtained from lung adenocarcinoma by bronchoscopy were tested for ALK protein expression and gene fusion respectively by immunohistochemistry （IHC） using Ventana D5F3 antibody and fluorescence in situ hybridization （FISH） using ALK break apart probe.Results sixty-five of the 74 samples were successfully tested by FISH （87.8％,65/74）.There were 5 FISH-positive cases （7.7％,5/65）,all with advanced stage carcinoma.Among these five FISH-positive cases,3 were IHC-positive （4.1％,3/74） and 2 IHC-negative cases.All the other 69 samples were IHC-negative,including nine FISH-uninformative samples （7 samples were less than 50 tumor cells and 2 samples with weak FISH signal）.Both ALK IHC and FISH results were not correlated with age,sex,history of smoking,histological classification,differentiation and lymph node metastasis.Conclusions Bronchoscopic specimens of lung cancer can be used to detect ALK expression and gene fusion.Inmunohistochemistry in combination with FISH test may be more favorable for ALK test.

关 键 词：支气管镜 肺肿瘤 腺癌 间变性淋巴瘤激酶 免疫组织化学 原位杂交 荧光 

分 类 号：R734.2[医药卫生—肿瘤]