title: [The research of clinical pathological features of ALK positive lung cancer in 525 patients and the discussion of detection methods].
abstract: BACKGROUND
  The fusion (rearrangement) of anaplastic lymphoma kinase (ALK) gene has been identified as an import factor to the tumorigenesis and development of lung cancer. ALK tyrosine kinase inhibitors (ALK-TKIs) have been proved to have good effects to ALK positive lung cancers. The increasement of the relevance ratio of ALK will be very important to patients. The aim of this study is to investigate the clinical pathological features of ALK positive lung cancer, and the roles of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) in screening and confirming the ALK positive cases in the testing flow of ALK.
  
  
  METHODS
  IHC analysis of ALK in tumor specimens was performed on 525 lung cancer patients. 34 cases among them were confirmed by FISH.
  
  
  RESULTS
  The positive incidence of ALK by IHC was 5.14% (27/525). The ALK positive patients were significantly younger than ALK negative patients (P<0.05), and femal was predominant (P<0.05). The proportion of solid predominant adenocarcinoma was significantly higher in ALK positive patients (P<0.05). While acinar and lepidic predominant adenocarcinoma were significantly lower in ALK positive patients (P<0.05). FISH was applied in 34 cases. The coincidence rate was increased with the increasement of positive intensity of IHC staining. All the IHC positive cases with or without EGFR mutation must be confirmed by FISH.
  
  
  CONCLUSIONS
  IHC is a reliable detection method to screening the ALK in lung cancer, and then enhance the relevance ration. To make a definite diagnosis of ALK positive lung cancer, FISH is a significant detection method.
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Pathology, Beijing Chui Yang Liu Hospital, Beijing 100022, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Oncology and Radiation Sickness, Cancer Center, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Baoshan
authors.initials: B
authors.lastname: Cao
authors.affiliation: Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Oncology and Radiation Sickness, Cancer Center, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liang
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Yuxiang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Jiangfeng
authors.initials: J
authors.lastname: You
authors.affiliation: Gene Tech (Shanghai) Company Limited, Beijing 100053, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Pathology, Peking University, Health Science Center/Peking University Third Hospital, Beijing 100191, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis / Q000201:enzymology* / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; C512478:EGFR protein, human; D066246:ErbB Receptors; D020794:Receptor Protein-Tyrosine Kinases