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Autor(en) / Beteiligte
Titel
Comparison of IHC, FISH and RT-PCR methods for detection of ALK rearrangements in 312 non-small cell lung cancer patients in Taiwan
Ist Teil von
  • PloS one, 2013-08, Vol.8 (8), p.e70839-e70839
Ort / Verlag
United States: Public Library of Science
Erscheinungsjahr
2013
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
  • Recently Echinoderm microtubule-associated protein-like 4- anaplastic lymphoma kinase (EML4-ALK) fusion gene has become an important biomarker for ALK tyrosine kinase inhibitor (crizotinib) treatment in NSCLC. However, the best detection method and the significance of EML4-ALK variant types remain uncertain. Reverse transcriptase-polymerase chain reaction (RT-PCR), fluorescence in Situ hybridization (FISH) and Immunohistochemical (IHC) stain were performed on tumor tissues of 312 NSCLC patients for detection of ALK rearrangements. Mutation analyses for EGFR and KRAS genes were also performed. Thirteen of the 312 patients (4.17%) had ALK rearrangements detected by RT-PCR. If RT-PCR data was used as the gold standard, FISH tests had a low sensitivity (58.33%), but very good specificity (99.32%). IHC stain had better sensitivity (91.67%) than FISH, but lower specificity (79.52%), when the cut off was IHC2+. All of the 8 patients with high abundance of EML4-ALK positive cells in tumor tissues (assessed by the signal intensities of the RT-PCR product), were also have high expression of ALK protein (IHC3+), and positive for FISH, except one failed in FISH. Variants 3a+3b (4/5, 80%) of EML4-ALK fusion gene were more common to have high abundance of EML4-ALK positive cells in tumor tissues than variant 1 (1/3, 33.3%). Meta-analysis of the published data of 2273 NSCLC patients revealed that variant 3 (23/44, 52.3%) was the most common type in Chinese population, while variant 1 (28/37, 75.7%) was most common in Caucasian. Among the three detection methods, RT-PCR could detect not only the presence of EML4-ALK fusion gene and their variant types, but also the abundance of EML4-ALK positive cells in NSCLC tumor tissues. The latter two factors might affect the treatment response to anti-ALK inhibitor. Including RT-PCR as a diagnostic test for ALK inhibitor treatment in the prospective clinical trials is recommended.
Sprache
Englisch
Identifikatoren
ISSN: 1932-6203
eISSN: 1932-6203
DOI: 10.1371/journal.pone.0070839
Titel-ID: cdi_plos_journals_1430411690
Format
Schlagworte
Abundance, Adult, Aged, Aged, 80 and over, ALK protein, Animal tissues, Base Sequence, Biomarkers, Carcinoma, Non-Small-Cell Lung - diagnosis, Carcinoma, Non-Small-Cell Lung - genetics, Carcinoma, Non-Small-Cell Lung - metabolism, Care and treatment, Clinical trials, Comparative analysis, Diagnostic systems, DNA Mutational Analysis, Enzyme inhibitors, Epidermal growth factor receptors, Female, Fluorescence, Fluorescence in situ hybridization, Fusion protein, Gene Rearrangement, Genetic aspects, Humans, Immunohistochemistry - methods, In Situ Hybridization, Fluorescence - methods, Inhibitors, K-Ras protein, Kinases, Kinesin - genetics, Kinesin - metabolism, Lung cancer, Lung cancer, Non-small cell, Lung diseases, Lung Neoplasms - diagnosis, Lung Neoplasms - genetics, Lung Neoplasms - metabolism, Lymphoma, Male, Medical research, Meta-Analysis as Topic, Methods, Middle Aged, Mutation, Non-Hodgkin's lymphomas, Non-small cell lung carcinoma, Oncogene Proteins, Fusion - genetics, Oncogene Proteins, Fusion - metabolism, Pathology, Patients, Polymerase chain reaction, Protein-tyrosine kinase, Proto-Oncogene Proteins - genetics, Proto-Oncogene Proteins p21(ras), ras Proteins - genetics, Receptor Protein-Tyrosine Kinases - genetics, Receptor Protein-Tyrosine Kinases - metabolism, Receptor, Epidermal Growth Factor - genetics, Reproducibility of Results, Reverse Transcriptase Polymerase Chain Reaction - methods, RNA-directed DNA polymerase, Sensitivity, Sensitivity and Specificity, Taiwan, Tyrosine, Young Adult

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