全自动免疫组化筛查ALK基因融合非小细胞肺癌及其病理特征  

Screen of Non-small Cell Lung Cancer with Anaplastic Lymphoma Kinase Fusion Gene by Automatic Immunohistochemical Method and Its Pathological Features

作　　者：冯强[1] 彭森[1] 刘霞[1] 

机构地区：[1]徐州市中心医院,江苏徐州221009

出　　处：《北华大学学报（自然科学版）》2016年第2期209-212,共4页Journal of Beihua University（Natural Science）

基　　金：江苏省青年基金项目(BK20141026)

摘　　要：目的探讨全自动免疫组化筛查间变性淋巴瘤激酶(ALK)基因融合非小细胞肺癌的临床特点及病理特征.方法选取经病理检查确诊的554例非小细胞肺癌组织,采用Ventana抗ALK试剂和全自动免疫组化(IHC)染色检测ALK状态,分析ALK基因融合非小细胞肺癌的临床特点和病理特征.结果本次研究的554例非小细胞肺癌患者组织中,共筛选出34例ALK阳性,占6.14%;年龄<60岁的非小细胞肺癌患者ALK阳性率8.69%,明显高于年龄≥60岁的3.62%,差异具有显著统计学意义(P<0.01);男性患者ALK阳性率6.71%高于女性5.21%,但差异无统计学意义(P>0.05).组织形态学方面,34例ALK阳性非小细胞肺癌中28例为肺腺癌,6例为非肺腺癌.16例实体型为主腺癌合并黏液产生,7例腺泡型为主腺癌,1例为乳头型为主腺癌,4例为浸润性黏液腺癌,4例为鳞状细胞癌.EGFR基因突变检测显示:仅有1例合并该基因突变,其余均为野生型.9例IHC阳性样本,9例ALK基因融合非小细胞肺癌,9例IHC阴性样本经荧光原位杂交技术检测和RT-PCR检测均为阴性结果,6例IHC染色可能为阳性,经荧光原位杂交技术检测均显示为ALK融合阴性.结论 ALK基因融合肺癌是非小细胞肺癌一新的分子亚型,具有独特的临床表现和病理形态;Ventana抗ALK试剂和IHC染色是检测ALK阳性非小细胞肺癌首选方法,对提高该类型肺癌的检出率及个体化治疗具有重要意义.Objective To explore the automatic immunohistochemical method for the screen of non-small cell lung cancer with anaplastic lymphoma kinase（ ALK） and its clinical pathological features. Methods 554 cases of non-small cell lung cancer diagnosed by pathological examination were enrolled in this study. The status of ALK was detected by Ventana anti ALK reagent and IHC staining,and the clinical characteristics and pathological features of ALK gene were analyzed. Results Among of 554 patients with non-small cell lung cancer,34 cases showed positive ALK（6. 14%）. The positive rate of the patients under 60 years old（8. 69%）was significantly higher than that of the elder patients（3. 62%）（ P 0. 01）. The positive rate of male patients（6. 71%）was higher than female patients（5. 21%）,but the difference was not statistically significant（P 0. 05）. The results of tectology found that,among of 34 cases with ALK positive non-small cell lung cancer,28 cases were lung adenocarcinoma,5 cases were not lung adenocarcinoma,16 cases were solid adenocarcinoma with grume,7 cases were alveolar adenocarcinoma,1 case was papillary carcinoma,4 cases were invasive mucinous adenocarcinoma,and 4 cases were squamous cell carcinoma. EGFR gene mutation test showed that only 1 case combined with the mutation,and the rest were all wild type. Besides,9 cases were IHC positive samples,9 cases were non-small cell lung cancer with ALK gene fusion,9 cases were IHC negative samples determined by fluorescence in situ hybridization and RT-PCR detection. The other 6 cases of possible positive by IHC staining were determined to be ALK fusion negative by fluorescence in situ hybridization. Conclusion ALK gene fusion lung cancer is a new molecular subtype of non-small cell lung cancer. It has unique clinical feature and pathological morphology. Ventana anti ALK reagent and IHC staining method are the first choice for the test of ALK positive non-small cell lung cancer,which has important significance to improve the detection rate and

关 键 词：非小细胞肺癌 全自动免疫组化 间变性淋巴瘤激酶 

分 类 号：R734.2[医药卫生—肿瘤]