Zhang Chen, Randolph Melissa L, Jones Kelly J, Cramer Harvey M, Cheng Liang, Wu Howard H
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Ind., USA.
Acta Cytol. 2015;59(2):213-8. doi: 10.1159/000430083. Epub 2015 May 12.
Anaplastic lymphoma kinase (ALK) immunohistochemical staining on formalin-fixed paraffin-embedded tissue or cell blocks (CB) has been reported as an effective alternative to fluorescence hybridization in situ (FISH) for the detection of ALK gene rearrangement. However, CB frequently lack adequate cellularity even when the direct smears are cellular. This study aims to assess the utility of ALK immunocytochemical (ICC) staining on direct smears using the cell transfer (CT) technique for the detection of ALK rearrangement.
Fine-needle aspiration (FNA) cases of lung adenocarcinoma in which the ALK status had been determined by FISH on CB or a concurrent biopsy were identified. ICC staining for ALK was performed on alcohol-fixed Papanicolaou-stained direct smears using the CT technique. ALK immunoreactivity was evaluated using a modified semiquantitative scale. Results were compared with those of FISH.
A total of 47 FNA specimens were included. Five of 7 FISH-positive cases showed positive ALK ICC staining (71.4%), and 39 of 40 FISH-negative cases were negative on ALK ICC staining (97.5%). The overall correlation between ALK ICC and FISH was 93.6%.
ICC performed on FNA smears using the CT technique is an alternative method for the assessment of ALK rearrangement, especially when CB lack adequate cellularity.
据报道，在福尔马林固定石蜡包埋组织或细胞块（CB）上进行间变性淋巴瘤激酶（ALK）免疫组化染色是检测ALK基因重排的一种有效替代荧光原位杂交（FISH）的方法。然而，即使直接涂片细胞丰富，CB也常常细胞数量不足。本研究旨在评估使用细胞转移（CT）技术对直接涂片进行ALK免疫细胞化学（ICC）染色检测ALK重排的实用性。
确定通过对CB进行FISH或同时活检已确定ALK状态的肺腺癌细针穿刺（FNA）病例。使用CT技术对酒精固定的巴氏染色直接涂片进行ALK的ICC染色。使用改良的半定量量表评估ALK免疫反应性。将结果与FISH结果进行比较。
共纳入47个FNA标本。7例FISH阳性病例中有5例ALK ICC染色阳性（71.4%），40例FISH阴性病例中有39例ALK ICC染色阴性（97.5%）。ALK ICC与FISH的总体相关性为93.6%。
使用CT技术对FNA涂片进行ICC是评估ALK重排的一种替代方法，尤其是当CB细胞数量不足时。
