免疫组织化学和荧光原位杂交检测肺腺癌ROS1表达的对比  

Comparison between IHC and FISH detections of ROS1 expression in lung adenocarcinomas

作　　者：梁小芹[1] 王玲[1] 刘凤磊[1] 王卓[1] 赵凤辉[1] 郭应芳[1] 王金穗[1] 

机构地区：[1]甘肃省人民医院病理科,兰州730000

出　　处：《临床与实验病理学杂志》2016年第8期882-886,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：甘肃省科技计划资助(144FKCA095)

摘　　要：目的 比较免疫组织化学（immunohistochemistry,IHC）和荧光原位杂交（fluorescent in situhybridization,FISH）技术在检测肺腺癌中ROS1蛋白表达和融合基因的差异性和一致性,评估IHC在临床上的应用价值。方法 应用IHC和FISH技术对332例肺腺癌中ROS1蛋白表达和融合基因进行检测,比较两者检测的结果和相关性,并探讨ROS1融合基因与临床病理特征之间的关系。结果 332例肺腺癌中FISH阳性者13例,阴性者319例,ROS1融合基因阳性率为3.9%;ROS1蛋白表达结果：0者312例,1＋者2例,2＋者5例,3＋者13例,ROS1蛋白过表达率为6.0%;经FISH检测312例ROS1蛋白表达为0的标本无ROS1融合基因,2例1＋的标本中也无ROS1融合基因;5例2＋的标本中有2例ROS1融合基因,13例3＋的标本中11例有ROS1融合基因;IHC检测0和1＋、2＋、3＋标本FISH检测阳性符合率分别为0（0/314）、40%（2/5）和84.6%（11/13）;IHC检测ROS1蛋白为2＋～3＋的标本中72.2%（13/18）显示ROS1融合基因,0～1＋患者中无1例有ROS1融合基因（Kappa系数=0.831,P〈0.01）;IHC检测ROS1蛋白表达的敏感性和特异性分别100%和98.4%。结论 IHC检测ROS1蛋白表达和FISH检测ROS1融合基因,两种方法有较高的符合率,一致性较好,IHC有较高的敏感性和特异性,可作为临床检测肺腺癌ROS1融合基因的简单而有效的方法。Purpose To compare the difference and consistence between immunohistochemistry （IHC） to detect ROS1 protein expression and fluorescent in situ hybridization （FISH） to detect ROS1 fusion gene in lung adenocarcinomas and to assess IHC clinical value. Methods Immunohistochemistry and FISH were used to detect ROS1 protein expression and ROS1 fusion gene in 332 cases of lung adenocarcinomas, respectively. The correlation was examined between ROS1 IHC and FISH and the clinicopathologic characteristics of lung adenocarcinomas with ROS1 fusion gene were described. Results Of 332 cases of lung adenocarcinomas, there were 13 positive cases and 319 negative cases detected by fluorescence in situ hybridization, with the rate of ROS1 gene fusion of 3.9%. 312 showed no ROS1 protein expression （0）, 2 showed mild expression （1 ＋ ）, 5 had moderate expression （2 ＋ ） and 13 had strong expression （3 ＋ ）. The rate of ROS1 protein over expression was 6. 0%. Positive coincidence rate of 0 - 1 ＋ , 2 ＋ and 3 ＋ positive case in immunohistochemistry with fluorescence in situ hybridization were 0 （0/314）, 40% （2/5） and 84. 6% （13/15）, respectively. There were 72. 2 % （13/18） with ROS1 of 2 ＋-3 ＋ in immunohistochemistry while 0 （0/314） with ROS1 of 0-1 ＋ showing the fusion gene of ROS1 fluorescence in situ hybridization detection, with Kappa coefficients of 0. 831 （P 〈0. 01 ）. ROS1 protein expression in tumor ceils was 100% sensitivity and 98.4% specificity for ROS1 fusion gene by FISH. Conclusion The detection of immunohistochemistry and fluorescence in situ hybridization is with high coincidence rate and good consistency. ROS1 IHC is an effective screening tool for this rare but clinically important subset of lung adenocarcinomas.

关 键 词：肺肿瘤 肺腺癌 ROS1 免疫组织化学 荧光原位杂交 

分 类 号：R734.2[医药卫生—肿瘤]