Shukla Saumya, Husain Nuzhat, Gupta Anurag, Anand Nidhi
Department of Pathology, Dr. Ram Manohar Lohia, Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
J Cytol. 2019 Jan-Mar;36(1):8-12. doi: 10.4103/JOC.JOC_127_18.
The anaplastic lymphoma kinase (ALK) gene rearrangement is a predictive and prognostic marker in pulmonary adenocarcinoma. A series of clinical and pathological features have been documented in patients who harbor this translocation.
The objectives of this study were to analyze the specific cytomorphological features of lung adenocarcinoma that harbored the ALK gene rearrangement and to compare the morphological features with the mutation-negative cases.
The study sample of 40 cases included 15 ALK-positive cases and 25 ALK-negative cases. After the diagnosis was established, testing for ALK rearrangement was on the histopathology sample. The corresponding fine-needle aspiration cytology slides were retrieved from the records and cytomorphological features were analyzed.
A comparison of pattern between the ALK-positive and ALK-negative group revealed that the sheet-like pattern and singly scattered cells were more common in the ALK-positive group. Moderate-to-severe nuclear pleomorphism was identified in 80% of ALK-positive cases and 72% of ALK-negative cases. The presence of mucinous features and/or signet ring morphology was the most striking feature of ALK-positive cases with value of 0.002. The presence of necrosis in the background was identified in 80% of ALK-positive cases and was statistically significant ( = 0.001).
This is among the few studies from India, where a detailed analysis of the cytomorphological features of cases with ALK phenotype versus the mutation negative cases has been performed.
间变性淋巴瘤激酶（ALK）基因重排是肺腺癌的一种预测和预后标志物。携带这种易位的患者已有一系列临床和病理特征的记录。
本研究的目的是分析携带ALK基因重排的肺腺癌的特定细胞形态学特征，并将其形态学特征与突变阴性病例进行比较。
40例研究样本包括15例ALK阳性病例和25例ALK阴性病例。确诊后，在组织病理学样本上进行ALK重排检测。从记录中检索相应的细针穿刺细胞学玻片并分析细胞形态学特征。
ALK阳性组和ALK阴性组模式的比较显示，片状模式和单个散在细胞在ALK阳性组中更常见。80%的ALK阳性病例和72%的ALK阴性病例存在中度至重度核多形性。黏液样特征和/或印戒形态的存在是ALK阳性病例最显著的特征，P值为0.002。80%的ALK阳性病例背景中有坏死，具有统计学意义（P = 0.001）。
这是印度为数不多的研究之一，其中对具有ALK表型的病例与突变阴性病例的细胞形态学特征进行了详细分析。
