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EML4-ALK在非小细胞肺癌中的表达及其临床病理特征
作者:杨文丽  申旺  彭雨  周伟  李荣岗  张鑫  黄辉 
单位:中山大学附属江门中心医院病理科  广东 江门 529030 江门市五邑中医院检验科  广东 江门 529000 中山大学附属江门中心医院肿瘤科  广东 江门 529030 
关键词: 非小细胞肺/病理学 腺癌/病理学 磷酸转移酶类/生物合成 免疫组织化学 
DOI:R734.2;R730.23
出版年,卷(期):页码:2018,33(3):250-254
摘要:

目的 探讨免疫组织化学(immunohistochemistry,IHC)在检测非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者棘皮动物微管相关蛋白4(echinoderm microtubule-associated protein-like 4 gene,EML4)和间变淋巴瘤激酶(anaplastic lymphoma kinase gene,ALK)融合蛋白的表达情况及其临床病理特征。方法 收集NSCLC组织标本384例,其中手术标本245例,穿刺标本139例,采用IHC法检测组织中的EML4-ALK融合蛋白。结果 EML4-ALK融合蛋白在手术标本和穿刺标本中的阳性率分别为9.0%和12.2%(P>0.05)。EML4-ALK融合蛋白在NSCLC患者腺癌中的阳性率为13.0%,高于其他类型的阳性率(0.0%),差异具有统计学意义(P<0.01);Ⅲ~Ⅳ期NSCLC患者的阳性率高于Ⅰ~Ⅱ期(18.0%vs 6.5%,P<0.05)。在NSCLC腺癌患者中,EML4-ALK融合蛋白阳性率在性别、年龄、吸烟史、分化程度、临床分期和淋巴结转移方面比较,差异均具有统计学意义(均P<0.05),而在腺癌的组织类型和肿瘤大小方面比较,差异均无统计学意义(均P>0.05)。结论 IHC法检测EML4-ALK融合蛋白可用于NSCLC患者的诊断和筛查,EML4-ALK融合蛋白在NSCLC尤其NSCLC腺癌中具有独特的临床表现和病理特征。

Objective To explore the expression and clinical pathological features of echinoderm microtubule-associated protein-like 4 gene and the anaplastic lymphoma kinase gene(EML4-ALK) fusion protein in non-small-cell lung cancer(NSCLC) patients by immunohistochemistry(IHC) tests.Methods Three-hundreds-and-eighty-four cases of NSCLC tissues were collected, including 245 cases of surgical specimens and 139 cases of puncture specimens. IHC was used to detect EML4-ALK fusion protein in the tissue.Results The positive rates of EML4-ALK fusion protein in surgical specimens and puncture specimens were 9.0% and 12.2% respectively, with no significant difference (P>0.05). The positive rate of EML4-ALK fusion protein in adenocarcinoma of NSCLC patients was higher than those of other pathological types (13.0% vs 0.0%,P<0.01). Besides, the positive rates of EML4-ALK was higher in stage Ⅲ-Ⅳ NSCLC patients than that in stage Ⅰ-Ⅱ patients (18.0% vs 6.5%, P<0.05). Moreover, in NSCLC adenocarcinoma patients, the positive rate of EML4-ALK fusion protein was significantly different in terms of gender, age, smoking history, differentiation, clinical stage and lymphatic metastasis (all P<0.05), but was not different in terms of adenocarcinoma tissue type or tumor size (both P>0.05).Conclusion Detecting EML4-ALK fusion protein by IHC can be used in the diagnosis and screening of NSCLC patients. EML4-ALK fusion protein has unique clinical manifestations and pathological features in NSCLC, especially in NSCLC adenocarcinoma.

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