Medical Oncology Department, Vall d'Hebron University Hospital, Universidad Autónoma de Barcelona, Barcelona, Spain.
PLoS One. 2013;8(1):e52261. doi: 10.1371/journal.pone.0052261. Epub 2013 Jan 24.
Anaplastic Lymphoma Kinase (ALK) positivity represents a novel molecular target in a subset of Non-Small Cell Lung Cancers (NSCLC). We explore Fluorescence in situ Hybridization (FISH) and Immunohistochemistry (IHC) as diagnostic methods for ALK positive patients and to describe its prevalence and outcomes in a population of NSCLC patients.
NSCLC patients previously screened for Epidermal Growth Factor Receptor (EGFR) at our institution were selected. ALK positive patients were identified by FISH and the value of IHC (D5F3) was explored.
ninety-nine patients were identified. Median age was 61.5 years (range 35-83), all were caucasians, eighty percent were adenocarcinomas, fifty-one percent were male and thirty-eight percent were current smokers. Seven (7.1%) patients were ALK positive by FISH, thirteen (13.1%) were EGFR mutant, and 65 (65.6%) were negative/Wild Type (WT) for both ALK and EGFR. ALK positivity and EGFR mutations were mutually exclusive. ALK positive patients tend to be younger than EGFR mutated or wt patients. ALK positive patients were predominantly never smokers (71.4%) and adenocarcinoma (71.4%). ALK positive and EGFR mutant patients have a better outcome than negative/WT. All patients with ALK FISH negative tumours were negative for ALK IHC. Out of 6 patients positive for ALK FISH with more tissue available, 5 were positive for ALK IHC and 1 negative.
ALK positive patients represent 7.1% of a population of selected NSCLC. ALK positive patients have different clinical features and a better outcome than EGFR WT and ALK negative patients. IHC is a promising method for detecting ALK positive NSCLC patients.
间变性淋巴瘤激酶（ALK）阳性是一小部分非小细胞肺癌（NSCLC）的新型分子靶点。我们探索荧光原位杂交（FISH）和免疫组织化学（IHC）作为ALK 阳性患者的诊断方法，并描述其在 NSCLC 患者人群中的患病率和结局。
选择我院先前筛选表皮生长因子受体（EGFR）的 NSCLC 患者。通过 FISH 鉴定 ALK 阳性患者，并探索 IHC（D5F3）的价值。
确定了 99 名患者。中位年龄为 61.5 岁（范围 35-83），均为白种人，80%为腺癌，51%为男性，38%为当前吸烟者。7 名（7.1%）患者 FISH 检测为 ALK 阳性，13 名（13.1%）为 EGFR 突变，65 名（65.6%）为 ALK 和 EGFR 均为阴性/野生型（WT）。ALK 阳性和 EGFR 突变是相互排斥的。ALK 阳性患者比 EGFR 突变或 WT 患者年轻。ALK 阳性患者主要为从不吸烟者（71.4%）和腺癌（71.4%）。ALK 阳性和 EGFR 突变患者的结局优于阴性/WT。所有 ALK FISH 阴性肿瘤患者的 ALK IHC 均为阴性。在有更多组织可供检测的 6 名 ALK FISH 阳性患者中，5 名 ALK IHC 阳性，1 名阴性。
ALK 阳性患者占选定 NSCLC 人群的 7.1%。ALK 阳性患者具有不同的临床特征，其结局优于 EGFR WT 和 ALK 阴性患者。IHC 是一种很有前途的检测 ALK 阳性 NSCLC 患者的方法。
