胸水细胞检测.pdfVIP

Original Article Detection of ALK Rearrangements in Malignant Pleural Effusion Cell Blocks From Patients With Advanced Non-Small Cell Lung Cancer: A Comparison of Ventana Immunohistochemistry and Fluorescence In Situ Hybridization Weiya Wang, PhD;† Yuan Tang, MD;† Jinnan Li, MD; Lili Jiang, PhD; Yong Jiang, MD; and Xueying Su, PhD BACKGROUND: Surgical resections or tumor biopsies are often not available for patients with late-stage non-small cell lung cancer (NSCLC). Cytological specimens, such as malignant pleural effusion (MPE) cell blocks, are critical for molecu- lar testing. Currently, diagnostic methods to identify anaplastic lymphoma kinase (ALK ) rearrangements include fluores- cence in situ hybridization (FISH), real-time reverse transcriptase-polymerase chain reaction (RT-PCR), and immunohistochemistry (IHC). In the current study, the authors compared Ventana ALK IHC assays and ALK FISH to detect ALK rearrangements in MPE cell blocks from patients with advanced NSCLC. METHODS: The ALK IHC assay and ALK FISH were performed on 63 MPE cell blocks. RT-PCR analysis was performed as additional validation in cases in which a discrepancy was observed between the IHC assay and FISH results. RESULTS: The Ventana ALK IHC assay was found to be informative for all 63 samples, and 8 cases were positive. Fifty-eight cases were interpretable for FISH detection, and 6 were positive. The concordance between IHC and FISH was 100% among the 58 cases. Of the 5 uninterpretable ALK FISH cases, 2 cases and 3 cases, respectively, were ALK IHC positive and negative. One of the 2 ALK IHC-positive cases also demonstrated a positive result in the RT-PCR assay and the patient benefited