Department of Pathology, Osaka Police Hospital, Tennouji-ku, Osaka, Japan.
J Clin Pathol. 2010 Dec;63(12):1066-70. doi: 10.1136/jcp.2010.081166. Epub 2010 Oct 9.
A subset of lung cancers harbours the fusion gene echinoderm microtubule-associated protein-like-4-anaplastic lymphoma kinase (EML4-ALK). Recently, immunohistochemistry for ALK has shown sensitivity for the detection of EML4-ALK-positive lung adenocarcinoma almost equal to that of the fluorescence in situ hybridisation (FISH) assay.
To study the clinicopathological features of EML4-ALK-positive lung adenocarcinoma in a large number of surgically resected samples using immunohistochemistry, in order to establish a useful screening method for EML4-ALK-positive lung adenocarcinoma.
Immunohistochemistry for ALK was used to screen for EML4-ALK-positive lung adenocarcinomas in 254 cases of surgically resected samples.
EML4-ALK-positive cases were detected in 3.1% of lung adenocarcinomas (8/254). EML4-ALK-positive lung adenocarcinomas showed significant associations with intra- and/or extra-cytoplasmic mucin (p=0.0001), and cribriform pattern with excessive extracytoplasmic mucin (p<0.0001). Signet-ring cell appearance alone lacked significance (p=0.149).
EML4-ALK-positive lung adenocarcinoma has a tendency to express a characteristic morphological pattern. The combined use of morphological feature analysis and immunohistochemistry may be a useful and cost effective screening method for EML4-ALK lung adenocarcinoma.
一部分肺癌存在棘皮动物微管相关蛋白样-4-间变性淋巴瘤激酶（EML4-ALK）融合基因。最近，免疫组织化学ALK 检测显示出对 EML4-ALK 阳性肺腺癌的敏感性，几乎与荧光原位杂交（FISH）检测相当。
通过免疫组织化学方法研究大量手术切除样本中 EML4-ALK 阳性肺腺癌的临床病理特征，以建立一种用于 EML4-ALK 阳性肺腺癌的有用筛查方法。
使用免疫组织化学方法对 254 例手术切除样本进行 ALK 检测，以筛选 EML4-ALK 阳性肺腺癌。
在 3.1%（8/254）的肺腺癌中检测到 EML4-ALK 阳性病例。EML4-ALK 阳性肺腺癌与细胞内和/或细胞外黏蛋白（p=0.0001）以及伴有过多细胞外黏蛋白的筛状模式（p<0.0001）显著相关。单纯印戒细胞外观无显著意义（p=0.149）。
EML4-ALK 阳性肺腺癌具有表达特征性形态模式的趋势。形态特征分析与免疫组织化学相结合可能是一种有用且具有成本效益的 EML4-ALK 肺腺癌筛查方法。
