Gupta Vani, Shukla Saumya, Husain Nuzhat, Kant Surya, Garg Rajiv
Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Cytol. 2019 Jan-Mar;36(1):13-17. doi: 10.4103/JOC.JOC_66_18.
Lung cancer is a leading cause of deaths attributed to cancer worldwide. Epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement are commonly found in patients of adenocarcinoma lung against, which targeted therapy is available. In this era of personalized medicine, it is a rationale to detect these molecular alterations in cases of lung carcinomas.
The objectives were to compare the diagnostic efficacy of cytological samples for the detection of EGFR and ALK protein expression using immunocytochemistry in nonsmall cell lung carcinoma.
We compared 22 cell blocks and biopsies for the detection of EGFR and ALK protein expression by immunohistochemistry (IHC). EGFR IHC was performed using EGFR Receptor (E746-A750 del Specific) (6B6) monoclonal antibody and ALK IHC was done using Ventana anti-ALK (D5F3) monoclonal primary antibody.
Two cases were found to be positive; 20 cases were negative for EGFR IHC both in biopsies and cell blocks. ALK IHC was positive in one case; negative in 21 cases. The results of IHC were also concordant for biopsies and cell blocks. The sensitivity and specificity were 100% for immunocytochemical detection of ALK and EGFR in cell blocks with respect to biopsies.
We conclude that cell blocks can serve as a potential substitute for biopsies for detection of EGFR and ALK protein by immunocytochemistry, whenever patient presents with effusion and biopsy cannot be done or when tissue is not adequate.
肺癌是全球癌症相关死亡的主要原因。表皮生长因子受体（EGFR）突变和间变性淋巴瘤激酶（ALK）重排在肺腺癌患者中常见，针对这些情况有靶向治疗方法。在这个个性化医疗的时代，在肺癌病例中检测这些分子改变是合理的。
目的是比较在非小细胞肺癌中使用免疫细胞化学检测EGFR和ALK蛋白表达的细胞学样本的诊断效能。
我们比较了22个细胞块和活检组织，通过免疫组织化学（IHC）检测EGFR和ALK蛋白表达。EGFR免疫组织化学使用EGFR受体（E746 - A750缺失特异性）（6B6）单克隆抗体进行，ALK免疫组织化学使用Ventana抗ALK（D5F3）单克隆一抗进行。
发现两例阳性；活检组织和细胞块中EGFR免疫组织化学检测均有20例阴性。ALK免疫组织化学检测1例阳性；21例阴性。免疫组织化学检测结果在活检组织和细胞块中也一致。细胞块中ALK和EGFR免疫细胞化学检测相对于活检组织的敏感性和特异性均为100%。
我们得出结论，当患者出现胸腔积液且无法进行活检或组织不足时，细胞块可作为通过免疫细胞化学检测EGFR和ALK蛋白的活检组织的潜在替代物。
