362例胰腺导管腺癌NTRK、ALK及错配修复蛋白表达谱研究及文献回顾  

Expression of NTRK,ALK and mismatch repair protein in pancreatic ductal adenocarcinoma:a study of 362 cases and review of literature

作　　者：刘笑玎 陆俊良[1] 庞钧译 陈龙云[1] 梁小龙 吴焕文[1] 梁智勇[1] LIU Xiao-ding;LU Jun-liang;PANG Jun-yi;CHEN Long-yun;LIANG Xiao-long;WU Huan-wen;LIANG Zhi-yong(Department of Pathology,Peking Union Medical College Hospital,Peking Union Medical Collegey Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pathology,Bejing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院病理科,北京100730 [2]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《诊断病理学杂志》2021年第5期321-326,共6页Chinese Journal of Diagnostic Pathology

基　　金：政府间国际科技创新合作重点专项(2017YFE0110300);中国医学科学院医学与健康科技创新工程(2016-I2M-1-002)。

摘　　要：目的探究胰腺导管腺癌(PDAC)NTRK、ALK及错配修复(mismatch repair,MMR)蛋白表达谱并回顾相关文献,深入探究PDAC的分子特点。方法回顾性收集北京协和医院2008-09—2014-07胰腺导管腺癌手术标本制作组织芯片(tissue microarray,TMA),并收集相应临床病理资料和预后数据;采用免疫组织化学染色检测NTRK、ALK及4种MMR蛋白(MLH1、PMS2、MSH2和MSH6的表达),并回顾TCGA数据库及既往相关文献报道。结果本研究中共纳入362例PDAC病例,中位年龄61岁,男性208例(57.5%),女性154例(42.5%),以Ⅰ-Ⅱ期病例为主(92.5%)。其中我们检测到1例NTRK阳性(0.3%)病例,总生存期(OS)为12个月,其组织学表现为经典型胰腺导管腺癌形态,未发现ALK阳性病例。TCGA数据库和既往文献报道在胰腺癌中NTRK及ALK阳性率均在1%以下。本研究病例均表达MMR蛋白,既往研究中MMR蛋白缺失病例比例在0~22%不等。结论通过免疫组织化学检测NTRK在胰腺导管腺癌中表达率低于1%,与既往研究结果类似,未发现ALK阳性病例及错配修复蛋白缺失(deficient MMR,d MMR)病例。本研究为首次基于较大样本量的中国PDAC队列中报道NTRK、ALK和MMR蛋白表达情况。Objective To explore the expression of NTRK,ALK,and mismatch repair(MMR)protein in pancreatic ductal adenocarcinoma(PDAC)with review of related studies.Methods We retrospectively collected PDAC surgically resected specimens and clinical data in Peking Union Medical College Hospital(PUMCH)from 2008-09 to 2017-07.Samples were stained by immunohistochemistry(IHC)to detect the expression of NTRK,ALK,MLH1,PMS2,MSH2,and MSH6.TCGA data were reviewed and summarized as well.Results This study enrolled 362 PDAC cases,and the median age was 61,including 208 males(57.5%)and 154 females(42.5%).Stage I-II accounted for the most(92.5%).We identified 1 NTRK-positive sample(0.3%)with the 12-month overall survival(OS),and the morphology of which was typical PDAC.No ALK-positive case was identified.According to the TCGA data,the positive rate of NTRK or ALK was lower than 1%.All samples had proficient MMR protein expression.The rate of deficient MMR(d MMR)expression was between 0-22%in the previous studies.Conclusions The positive rate of NTRK in this study is lower than 1%,which is consistent with the previous studies.No ALK-positive or d MMR cases are identified.This is the first study that reported the expression of NTRK,ALK,and MMR proteins based on a large Chinese PDAC cohort.

关 键 词：胰腺癌 免疫组化 分子病理 靶向治疗 

分 类 号：R365[医药卫生—病理学]