文章摘要

非小细胞肺癌患者组织原发灶和转移灶中ALK融合基因的研究

作者: 1王琳, 3许春伟, 2亓岽东, 1李丽, 4张俊萍, 3吴永芳, 3邰艳红, 3张博, 3邵云, 5方美玉, 2高文斌, 6张立英, 6田玉旺
1 山西医学科学院，山西大医院病理科，太原 030001
2 大连大学附属中山医院肿瘤科，辽宁 大连 116001
3 军事医学科学院附属医院病理科，北京 100071
4 山西医学科学院山西大医院生物治疗科，太原 030001
5 浙江省肿瘤医院中西医结合科，杭州 310021
6 中国人民解放军北京军区总医院病理科，北京 100700
通讯: 王琳 Email: 1141554200@qq.com
许春伟 Email: xuchunweibbb@163.com
李丽 Email: limuzi73@163.com
邵云 Email: shysep@163.com
DOI: 10.3978/j.issn.2095-6959.2015.12.026
基金: 吴阶平医学基金会临床科研专项资助基金项目, 320.6750.1360 浙江省卫生科研计划基金项目, 2013KYB051 浙江省中医药局科研基金项目, 2013ZQ005 军事医学科学院附属医院创新科研基金项目, ZH-2014-10

摘要

目的：研究晚期非小细胞肺癌(non-small cell lung cancer，NSCLC)原发灶和转移灶ALK融合基因阳性 率，探讨其相关性。方法：收集2013年1月至2015年5月中国人民解放军北京军区总医院、军事医学科 学院附属医院、浙江省肿瘤医院和大连大学附属中山医院原发灶384例，其中配对转移灶246例，统计 得出ALK融合基因阳性率并分析原发灶与转移灶ALK融合基因的一致性、ALK融合基因阳性与临床基 线资料间的关系。结果：ALK融合基因阳性率原发灶为11.46%(44/384)。ALK融合基因阳性率配对原 发灶为10.98%(27/246)，配对转移灶为7.32%(18/246)，配对的246对原发灶、转移灶组织中，转移灶 融合基因阳性而对应的原发灶融合基因阴性2例，原发灶融合基因阳性而对应的转移灶融合基因阴性 11例，转移灶较原发灶检出ALK融合基因阳性率高，两者差别有统计学意义(χ2=112.208，P=0.000)；转 移灶和原发灶ALK融合基因阳性的一致率好(κ=0.683，P=0.000），通过转移灶判断原发灶融合阳性的 情况，敏感性为59.26%(16/27)，特异性为99.09%(217/219)。结论：非小细胞肺癌中转移灶可以预测原 发灶ALK融合基因情况，在难以取得原发灶的情况下转移灶可以作为ALK融合基因测的备选手段。
关键词： 非小细胞肺癌 ALK融合基因 原发灶 转移灶

The study of ALK fusion in advanced primary non-small cell lung cancer and associated metastatic lesions

Authors: 1Wang Lin, 3XU Chunwei, 2QI Dongdong, 1LI Li, 4ZHANG Junping, 3WU Yongfang, 3TAI Yanhong, 3ZHANG Bo, 3SHAO Yun, 5FANG Meiyu, 2GAO Wenbin, 6ZHANG Liying, 6TIAN Yuwang
1 Department of Pathology, Shanxi Da Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030001
2 Department of Oncology, Zhongshan Hospital, Dalian University, Dalian Shenyang 116001
3 Department of Pathology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071
4 Department of Biological treatment, Shanxi Da Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030001
5 Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, Hangzhou 310021
6 Department of Pathology, the Military General Hospital of Beijing, Beijing 100700, China

CorrespondingAuthor: Wang Lin Email: 1141554200@qq.com

DOI: 10.3978/j.issn.2095-6959.2015.12.026

Abstract

Objective: To examine the positive rate of ALK fusion gene in primary and metastatic non-small cell lung cancer (NSCLC), and to investigate their relationships. Methods: From January 2013 to May 2015, 384 cases of primary NSCLC consisting of 246 cases of matched metastatic tumors and 47 cases of normal lung specimens as the control group were collected in the Military General Hospital of Beijing, Affiliated Hospital of Academy of Military Medical Sciences, Zhejiang Cancer Hospital, Zhongshan Hospital of Dalian University. The positive rate of ALK fusion gene among NSCLC population was figured out, thus the consistency of ALK fusion gene in advanced primary NSCLC and associated metastases and the relationship between ALK fusion gene and clinical data was analyzed. Results: The positive rate of ALK fusion gene on primary tumor was 11.46% (44/384). For those 246 matched cases, the positive rate on primary tumor was 10.98% (27/246), with that of metastases 7.32% (18/246). Among the 246 cases, there were 2 cases whose metastases were positive but primary tumors negative and 11 case whose primary tumor was positive but metastases negative. Positive rate of ALK fusion gene was higher in the primary lesions than metastases. It was of statistical significance between the two groups (χ2=112.208, P=0.000). The positive rate of primary tumors could be predicted by metastases (κ=0.683, P=0.000). The sensitivity was 59.26% (16/27) and the specificity was 99.09% (217/219). Conclusion: The metastases of non-small cell lung cancer can predict ALK fusion gene of the primary lesions. It can be used as alternative means for metastases to detect ALK fusion gene primary tumors which are not readily available.

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