Zhao Jing, Zhou Jianya, Chen Zhen, Wang Bo, Zhang Xiuming, Zhou Jianying, Ding Wei
Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou, China.
Int J Clin Exp Pathol. 2015 Mar 1;8(3):3344-8. eCollection 2015.
EML4-ALK rearrangement is detected in 2% to 7% of lung adenocarcinomas, these tumors are sensitive to crizotinib. The histologic feature of ALK translocated non-small-cell lung cancer (NSCLC) has been studied, presence of signet-ring cells was a powerful histologic indicator of ALK rearrangement, and this characteristic histology was present both in primary sites and metastases. However, the case we discribed here has different histomorphology in primary sites and metastases, but has the same genotype which both present ALK rearrangement, while absent of EGFR mutation, KRAS mutation and ROS1 rearrangement. This histologic heterogeneity may be a supplement of the histologic feature of ALK rearranged tumor. Moreover, genomic analysis can help distinguish clonal tumors from independent primaries.
在2%至7%的肺腺癌中可检测到EML4-ALK重排，这些肿瘤对克唑替尼敏感。ALK易位的非小细胞肺癌（NSCLC）的组织学特征已得到研究，印戒细胞的存在是ALK重排的有力组织学指标，并且这种特征性组织学在原发部位和转移灶中均存在。然而，我们在此描述的病例在原发部位和转移灶具有不同的组织形态学，但具有相同的基因型，均存在ALK重排，同时不存在EGFR突变、KRAS突变和ROS1重排。这种组织学异质性可能是ALK重排肿瘤组织学特征的一种补充。此外，基因组分析有助于区分克隆性肿瘤与独立的原发性肿瘤。
