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目的探讨荧光原位杂交(FISH)和免疫组化(IHC)两种方法筛选肺腺癌ALK基因突变患者的敏感性和一致性,并讨论ALK基因突变亚型的临床病理特征。方法收集2012年1月~2013年12月收治的肺腺癌患者标本60例,采用FISH和IHC(克隆号D5F3)检测ALK基因重排状态。结果 FISH检测发现11.7%(7/60)的患者发生了ALK基因重排,IHC检测发现13.3%(8/60)的患者有ALK蛋白的表达,以FISH为标准检测方法,则IHC检测ALK突变的敏感性和特异性分别是100%和98.3%,与FISH的一致性达98.4%。ALK基因重排患者年龄偏小,且均为EGFR野生型。结论采用D5F3抗体Ventanna系统进行ALK初筛,再联合FISH进行确认是一种经济、可靠的筛选ALK基因重排肺腺癌的方法。
Objective To investigate the sensitivity and consistency of screening ALK gene mutations in patients with lung adenocarcinoma by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC), and discuss the clinicopathological features of ALK gene mutation subtypes. Methods Sixty patients with lung adenocarcinoma from January 2012 to December 2013 were collected. ALK gene rearrangement status was detected by FISH and IHC (clone number D5F3). Results ALK gene rearrangement was found in 11.7% (7/60) patients by FISH. The expression of ALK protein was found in 13.3% (8/60) patients by IHC, and the ALK mutation was detected by IHC with FISH as the standard test The sensitivity and specificity were 100% and 98.3%, respectively. The consistency with FISH was 98.4%. Patients with ALK gene rearrangement are younger and both are EGFR wild-type. Conclusion It is an economical and reliable method to screen ALK gene for lung adenocarcinoma by using D5F3 antibody Ventanna system for primary screening of ALK combined with FISH.