title: Clinical application of immunocytochemical detection of ALK rearrangement on cytology slides for detection or screening of lung adenocarcinoma.
abstract: Immunohistochemical screening of Anaplastic lymphoma kinase (ALK) rearrangement has been regarded essential and routinely carried out to select treatment for lung adenocarcinoma. However, difficulty to approach a tumor by transbronchial lung biopsy (TBLB), it often fails to obtain tumor tissues whereas tumor cells are contained in cytology specimens simultaneously obtained when the bronchoscopy is done. Therefore we evaluated the expression of ALK protein by using immunohistochemistry (IHC) on TBLB specimens and immunocytochemistry (ICC) on brushing smear cytology slides in the same cases, and compared the concordance rate of IHC and ICC results. ICC was carried out on routine Papanicolau-stained slides after cytology diagnosis and decolorization.
  
  
  RESULTS
  Eighteen patients with adenocarcinoma were extracted in the Hirosaki University Hospital and the Hirosaki National Hospital. IHC and ICC results showed a very high concordance rate: sensitivity of ICC in comparison with IHC was 85.7% (6/7), specificity was 100% (11/11), positive predictive value was 100% (6/6), and negative predictive value was 91.6% (11/12). Detection of ALK rearrangement using ICC on routine Papanicolau cytology slides is considered to be advantageous for lung cancer treatments.
authors.affiliation: Department of Anatomic Pathology, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8563, Japan. h-tanaka@cc.hirosaki-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Tone
authors.forename: Akihito
authors.initials: A
authors.lastname: Hayashi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Kageaki
authors.initials: K
authors.lastname: Taima
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Shingo
authors.initials: S
authors.lastname: Takanashi
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
authors.forename: Akira
authors.initials: A
authors.lastname: Kurose
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D001999:Bronchoscopy; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D014178:Translocation, Genetic
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases