【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。更多还原

【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.更多还原