北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (4): 582-588.

• 论著 • 上一篇    下一篇

95例非小细胞肺癌患者的间变性淋巴瘤激酶融合基因表达情况、临床病理特点及预后

张梦雪1,裴斐1△,王田力2,韩翔3,由江峰1,邹鹏程1,王月琪1,李绪文1,刘鑫1,钟镐镐1,刘岩1,王玉湘1,王华1,张波1   

  1. (1. 北京大学基础医学院病理学系,北京100191;2. 北京大学第三医院放射科,北京100191;3. 北京大学第三医院呼吸内科,北京100191)
  • 出版日期:2014-08-18 发布日期:2014-08-18

Anaplastic lymphoma kinase fusion gene expression, clinical pathological characteristics and prognosis in 95 Chinese patients with non-small cell lung cancer

ZHANG Meng-xue1, PEI Fei1△, WANG Tian-li2, HAN Xiang3, YOU Jiang-feng1, ZOU Peng-cheng1, WANG Yue-qi1, LI Xu-wen1, LIU Xin1, ZHONG Hao-hao1, LIU Yan1, WANG Yu-xiang1, WANG Hua1, ZHANG Bo1   

  1. (1. Department of Pathology, Peking University School of Basic Medical Sciences, Beijing 100191, China; 2. Department of Radiology, Peking University Third Hospital, Beijing 100191, China; 3. Department of Respiratory Medicine, Peking University Third Hospital, Beijing 100191, China)
  • Online:2014-08-18 Published:2014-08-18

摘要: 目的:研究非小细胞肺癌患者的间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合基因的表达情况和临床病理特点。方法:从北京大学第三医院随机选择了有随访资料的95例非小细胞肺癌患者,采用ALK+插入式抗体强化免疫组织化学法(intercalated antibodyenhanced polymer, iAEP)和荧光原位杂交技术(fluorescence in situ hybridization, FISH)检测患者ALK融合基因的表达情况,并分析ALK融合基因阳性患者的临床病理特点、生存期和EGFR/KRAS基因突变情况。结果:采用ALK+iAEP法共筛选出8例ALK阳性病例,其中4例经FISH法证实存在ALK融合基因,检出率为4.2%(4/95),其中2例女性肺癌患者的组织学类型是实体性肺腺癌伴印戒细胞形态,另2例男性肺癌患者是腺鳞癌。4例肺癌患者中3例为非吸烟者,均无EGFR/KRAS基因突变,且均存活,其中有2例患者已存活超过5年。结论:ALK+iAEP法较常规ALK免疫组织化学法能明显提高肺癌患者ALK的检出率,可以作为初筛ALK阳性病例的方法,且阳性细胞的比例较阳性强度更重要。ALK融合基因在非小细胞肺癌患者中的检出率较低(<5%),同时可能提示预后较好。

关键词: 癌, 非小细胞肺, 间变性淋巴瘤激酶, 基因融合, 免疫组织化学, 原位杂交, 荧光

Abstract: Objective:To examine the prevalence of anaplastic lymphoma kinase (ALK) fusion gene in Chinese patients with non-small cell lung cancer (NSCLC). Methods: In this study, 95 patients with NSCLC and corresponding clinical information and formalin-fixed paraffin-embedded (FFPE) tissue blocks were included. Hematoxylin & eosin (HE) staining, conventional ALK immunochemistry (IHC) staining and intercalated antibody-enhanced polymer (iAEP) IHC staining, and dual-color split fluorescence in situ hybridization (FISH) for ALK fusion gene were performed. Results: Eight ALK-positive cases were detected using anti-ALK immunohistochemistry with the iAEP method, and FISH analyses revealed 4 patients of them who harbored the ALK fusion gene (4.2%, 4/95), including 2 cases of female patients with solid signet-ring cell adenocarcinoma and 2 cases of male patients with adenosquamous carcinoma. The positive cases were all non-smokers without EGFR/KRAS mutations. Furthermore, the positive cases all survived, and the overall postsurgery survival time of 2 cases was more than 5 years. Conclusion: ALK IHC with the iAEP method is better than conventional ALK IHC, and the percentage of the positive cells is more important than that of the intensity. ALK translocations were infrequent in the entire NSCLC patient population (<5%) with better prognosis.

Key words: Carcinoma, non-small-cell lung, Anaplastic lymphoma kinase, Gene fusion, Immunohistochemistry, In situ hybridization, fluorescence

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