Jia J, Zhao L L, Guo H Q, Zhao H, Zhang Z H, Guo L, Ying J M
Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2018 Jun 23;40(6):422-427. doi: 10.3760/cma.j.issn.0253-3766.2018.06.005.
To explore the feasibility of conventional smears and liquid-based cytologic slides of lymphatic metastasis specimens of lung adenocarcinoma acquired by fine needle aspiration cytology (FNAC) to detect the expression of anaplastic lymphoma kinase (ALK/D5F3) by immunocytochemistry (ICC) analysis. The lymphatic metastasis specimens of 147 lung adenocarcinoma, including 100 liquid-based cytologic slides and 47 conventional smears, were collected in this study. ALK fusion protein was detected by Roche Ventana ICC technology, which was compared with the ALK fusion gene assessed by fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR). The positive rate of ALK (D5F3) fusion protein in advanced lung adenocarcinoma acquired by FNAC was 11.6% (17/147), and 10.6% (5/47) and 12.0% (12/100) were reached in conventional smears and liquid-based cytologic slides, respectively.Among 147 cases, 57 cases including 17 positive cases and 40 negative cases were verified by RT-PCR and FISH. The whole coincidence rate reached 96.5% (55/57). The sensitivity and specificity of ALK (D5F3) fusion protein detected in lung adenocarcinoma acquired by FNAC were 94.1% (16/17) and 97.5% (39/40), respectively. The sensitivity and specificity were both 100% (5/5 of sensitivity and 10/10 of specificity) in conventional smears, while 91.7% (11/12) and 96.7% (29/30) in liquid-based cytologic slides. Conventional smears and liquid-based cytologic slides of FNAC samples can be used to perform ICC analysis of ALK (D5F3) expression in advanced lung adenocarcinoma, especially for patients who have no opportunity for surgery or whose resected samples are difficult to form cell block.
探讨细针穿刺细胞学检查（FNAC）获取的肺腺癌淋巴转移标本的传统涂片和液基细胞学玻片通过免疫细胞化学（ICC）分析检测间变性淋巴瘤激酶（ALK/D5F3）表达的可行性。本研究收集了147例肺腺癌的淋巴转移标本，其中包括100例液基细胞学玻片和47例传统涂片。采用罗氏Ventana ICC技术检测ALK融合蛋白，并与荧光原位杂交（FISH）或逆转录聚合酶链反应（RT-PCR）评估的ALK融合基因进行比较。FNAC获取的晚期肺腺癌中ALK（D5F3）融合蛋白的阳性率为11.6%（17/147），传统涂片和液基细胞学玻片中分别达到10.6%（5/47）和12.0%（12/100）。147例病例中，57例包括17例阳性病例和40例阴性病例经RT-PCR和FISH验证。总体符合率达到96.5%（55/57）。FNAC获取的肺腺癌中检测的ALK（D5F3）融合蛋白的敏感性和特异性分别为94.1%（16/17）和97.5%（39/40）。传统涂片中敏感性和特异性均为100%（敏感性5/5，特异性10/10），而液基细胞学玻片中分别为91.7%（11/12）和96.7%（29/30）。FNAC样本的传统涂片和液基细胞学玻片可用于对晚期肺腺癌中ALK（D5F3）表达进行ICC分析，尤其适用于没有手术机会或切除样本难以形成细胞块的患者。
