Ventana全自动免疫组化法检测不同来源肺腺癌ALK蛋白表达一致性的研究  

ALK Fusion Gene Assessment by Ventana Fully Automatic Immunohistochemistry in Different Specimens of Lung Adenocarcinoma

作　　者：陈学敬[1] 周立娟[1] 董宇杰[1] 蔡毅然[1] 张莉[1] 苏丹[1] 赵颖丽[1] 张晨[1] 张海青[1] 

机构地区：[1]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所病理科,北京101149

出　　处：《结核病与胸部肿瘤》2016年第4期279-282,共4页Tuberculosis and Thoracic Tumor

基　　金：北京市科委科技计划重：赶项目基金（D141100000214003）

摘　　要：目的探讨Ventana全自动免疫组化法检测不同标本肺腺癌间变性淋巴瘤激酶（ALK）蛋白表达的阳性率及一致性。方法收集606例肺腺癌标本，包括手术切除标本261例、小活检标本244例和胸水细胞块标本101例，采用Ventana全自动免疫组化染色仪、抗ALK兔单克隆抗体（D5F3）和超敏检测系统进行染色，检测ALK蛋白表达情况。结果606例肺腺癌标本中，49例ALK（＋），557例ALK（＋），阳性率为8．1％。手术切除标本261例中20例（＋），阳性率为7．7％；小活检标本244例中20例（＋），阳性率为8．2％；胸水细胞块标本101例中9例（＋），阳性率为8．9％；比较3种标本的ALK蛋白阳性率，差异不显著（P〈0．05）。606例标本中，同一患者兼具手术标本及小活检标本46例，有2对标本ALK（＋），其余标本均（-），检测结果完全一致；同一患者兼具小活检标本和胸水细胞块标本14例，小活检标本1例（＋），胸水细胞块标本3例（＋），2对标本检测ALK蛋白结果存在差异（14．3％，2／14）。结论Ventana全自动免疫组化检测可以作为肺腺癌ALK蛋白阳性患者克唑替尼靶向治疗的诊断方法。手术切除标本、小活检标本和胸水细胞块标本均可作为检测ALK蛋白的样本。肺腺癌原发灶与转移灶ALK蛋白检测是否存在差异性表达，有待进一步研究。Objective To analyze the protein expression and the expression consistency of anaplastic lymphoma kinase （ALK） in different specimens from lung cancer by Ventana automated immunohistochemical detection,and to assess the consistency in different sources of lung cancer specimens. Methods A total of 606 cases of lung adenocarcinoma specimens were collected from September 2013 to Novermber 2014, including 261 cases of surgical specimens, 244 cases of biopsies and 101 cases of pleural effusion cell block. Anti-ALK rabbit monoclonal antibody （ D5F3 ） and ultra- sensitive detection system were used to detect ALK fusion protein expression by Ventana automated imrnunohistochemistry. Results In the 606 cases of lung cancer specimens, 49 cases were demonstrated with positive ALK fusion protein; otherwise, 557 cases were negative. The total positive rate was 8.09%. 20 out of 261 cases of surgical specimens were found ALK protein expression,with the positive rate of 7.66%; The positive rate in biopsy specimens （ 20 of 244 cases） was 8.20% and 8.91% in pleural effusion cell （9 out of 101 cases）, respectively. There was no significant difference among these specimens （ P 〉 0.05）. In this cohort, 46 cases had both surgical specimens and biopsy specimens; only one paired specimens were detected with positive ALK fusion protein and the others were negative. Detection consistency of surgical specimens and biopsies for ALK fusion protein was 100% （46/46）; 14 cases had both biopsy and pleural effusion cell block specimens and one cases was positive of ALK fusion protein, but three cases of pleural effusion cell block specimens were found positive. Inconsistent expression of ALK fusion protein were present in two paired specimens （14.3%, 2/14）. Conclusion Ventana automated immunohistochemical staining to detect ALK fusion gene can beused for ALK fusion protein in lung adenocarcinoma. It is an economical and practical screening method for ALK fusion gene, which is related with the target therapy of Crizoti

关 键 词：肺腺癌 间变性淋巴瘤激酶 免疫组化 

分 类 号：R735.2[医药卫生—肿瘤]