免疫组化检测非小细胞肺癌ALK融合基因表达异常  

Exploration of ALK fused gene expression in non-small cell lung cancer patients by immunohistochemistry

作　　者：侯丹阳[1] 邵璐[2] 徐傲[3] 冷再君 伍权[4] 李传应[3] 陈柯[3] 徐修才[4] 操乐杰[1] 

机构地区：[1]安徽医科大学附属省立医院呼吸内科,合肥230001 [2]蚌埠医学院第二附属医院呼吸内科,蚌埠233000 [3]安徽医科大学附属省立医院病理科,合肥230001 [4]安徽医科大学附属省立医院中心实验室,合肥230001

出　　处：《临床与实验病理学杂志》2015年第5期542-547,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：2013安徽省卫生厅医学科研课题计划(13ZC001);2013安徽省科技攻关计划(1301042216)

摘　　要：目的探讨免疫组化(immunohistochemistry,IHC)在检测非小细胞肺癌(non-small cell lung cancer,NSCLC)中间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因表达异常的准确性,并观察ALK阳性患者的临床病理特征。方法收集NSCLC患者石蜡标本234例,使用兔单克隆D5F3抗体行ALK蛋白IHC检测,对其中ALK阳性标本采用反转录聚合酶链反应(reverse transcription-polymerase chain reaction,RT-PCR)检测验证。结果 234例NSCLC中,IHC检测ALK融合基因蛋白阳性率为8.97%(21/234),经RT-PCR检测验证有14例存在ALK基因融合,阳性率为5.98%(14/234);与组织学类型、年龄、分期相关(P<0.05),与患者性别、吸烟史、肿瘤分化程度无关。21例标本进行RT-PCR验证,IHC(+)时二者符合率为0,当IHC()或组织化学评分>120时,二者符合率为100%。结论尽管IHC检测ALK融合基因蛋白表达存在一定假阳性,但当IHC()或组织化学评分>120时与其他辅助检查一致性高具有诊断价值,是较为可靠的ALK筛查方法。IHC筛查及随后RT-PCR检测验证是发现ALK阳性肺癌经济可行的辅助诊断。Purpose To explore the accuracy of ALK fused gene expression by immunohistochemistry （IHC） in non-small cell lung cancer （NSCLC） patients, and to investigate the clinical and pathological features of ALK-positive NSCLC patients. Methods By u- sing rabbit monoelonal DSF3 antibody, ALK IHC was performed on 234 NSCLC patients. ALK positive cases were confirmed by reverse transcription-polymerase chain reaction （RT-PCR）. Results The positive incidence of ALK by IHC in 234 NSCLC specimens was 8.97% （21/234） , the positive rate of ALK fused gene verificated by RT-PCR was 5.98% （14/234）. There was significant difference with histological type, age, stage （ P 〈 0. 05 ） , but no significant difference with gender, smoking history, tumor differentiation. Of 21 cases of ALK-positive NSCLC patients, the consistency of IHC and RT-PCR was 0 when IHC was （ ＋ ） , however, when IHC was （ 卅 ） or immunohistochemical score was 〉 120, the consistency rate was 100%. Conclusion Although immunohistochemical expres- sion of ALK fused gene may have a certain false positive, IHC （卅 ） or immunohistochemical score 〉 120 show very high value for ALK fused gene RT-PCR followed by ALK immunohistochemistry in lung cancer is a economical and feasible method for the valuation of ALK fused gene.

关 键 词：肺肿瘤 非小细胞肺癌 间变性淋巴瘤激酶 表皮生长因子受体 免疫组织化学 反转录聚合酶链反应 

分 类 号：R734.2[医药卫生—肿瘤]