ALK融合蛋白在肺癌转移灶细针穿刺涂片标本中的研究  

ALK gene fusion protein expression in fine needle aspiration smear specimens of lung cancer

作　　者：贾佳[1] 李琳[1] 郭会芹[1] 赵琳琳[1] 赵焕[1] 王燕[2] 应建明[1] 张智慧[1] JIA Jia LI Lin GUO Hui-qin ZHAO Lin-lin ZHAO Huan WANG Yan YING jian-ming ZANG Zhi-hui(Department of Pathology Department of Medicine, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China)

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院病理科,北京100021 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021

出　　处：《诊断病理学杂志》2017年第7期494-498,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨基于免疫细胞化学技术检测肺癌细针穿刺细胞学传统涂片标本中ALK融合蛋白表达的可行性。方法收集61例肺癌患者的转移淋巴结细针穿刺传统涂片标本,应用免疫细胞化学(ICC)方法,用罗氏Ventana全自动免疫组化仪检测ALK融合蛋白的表达情况,并与相应的荧光原位杂交(FISH)检测结果进行比较。结果 61例细针穿刺传统涂片中,ICC检测ALK融合蛋白阳性表达率为9.9%(6/61),肺腺癌ALK融合蛋白阳性表达率为10.9%(6/55),其他鳞状细胞癌等均阴性(0/6),与相应FISH检测结果比较,符合率为93.8%(15/16)(Kappa=0.871),敏感性为85.7%(6/7),特异性为100%(9/9)。结论对于无法手术或者活检的晚期肺癌患者,细胞学细针穿刺传统涂片标本的ICC检测可以作为肺癌EML4-ALK融合基因FISH检测前的常规筛查手段。Objective To explore the feasibility of detecting the expression of EML4-ALK fusion protein in fine needle aspiration（ FNA） traditional smear specimens of lung cancer by immunocytochemistry（ ICC） technology. Methods Traditional smear cytology specimens by fine needle aspiration in 61 cases of lung cancer with lymph node metastasis were enrolled in this study. The expression of ALK fusion protein was detected by Roche Ventana ICC technology,compared with the ALK gene fusion assessed by fluorescence in situ hybridization（ FISH）. Results The positive rate of ALK fusion protein expression reached 9. 84%（ 6/61）,which showed a complete conformity with the FISH results in the 16 cases in histological specimens（ 93. 75%）（ Kappa = 0. 871）. To take the FISH results as a gold standard,ICC results had a high sensitivity（ 85. 71%） and specificity（ 100. 00%）. Conclusion ICC in FNA samples can be used in the clinic,especially for the advanced lung cancer patient that is difficult to get the tissue specimens,and the detection of ALK fusion protein expression is able to be taken as the screening before FISH analysis.

关 键 词：EML4-ALK 肺肿瘤 细针吸取细胞学 免疫细胞化学 

分 类 号：R734.2[医药卫生—肿瘤]