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Analysis of Histologic Features Suspecting Anaplastic Lymphoma Kinase (ALK)-Expressing Pulmonary Adenocarcinoma.

Choi IH, Kim DW, Ha SY, Choi YL, Lee HJ, Han J - J Pathol Transl Med (2015)

Bottom Line: However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation.Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer.In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma.

Methods: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status.

Results: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group.

Conclusions: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.

No MeSH data available.


Related in: MedlinePlus

Fluorescence in situ hybridization (FISH) of anaplastic lymphoma kinase (ALK)-rearranged pulmonary adenocarcinoma. Rearranged tumor nuclei show split signals (arrows) of 3´ (orange color) and 5´ (green color) ends of the gene hybridized using a dualcolor ALK break-apart FISH probe (Vysis LSI ALK Dual Color, Break Apart Rearrangement Probe, Abbott Molecular).
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f1-jptm-49-4-310: Fluorescence in situ hybridization (FISH) of anaplastic lymphoma kinase (ALK)-rearranged pulmonary adenocarcinoma. Rearranged tumor nuclei show split signals (arrows) of 3´ (orange color) and 5´ (green color) ends of the gene hybridized using a dualcolor ALK break-apart FISH probe (Vysis LSI ALK Dual Color, Break Apart Rearrangement Probe, Abbott Molecular).

Mentions: The FISH analysis for ALK rearrangement on FFPE tissue was examined using a probe specific to the ALK locus (Vysis LSI ALK dual-color, Break-Apart Rearrangement Probe, Abbott Molecular, Abbott Park, IL, USA). At least 50 nonoverlapping tumor cells were examined, and the cut-off value for positive ALK rearrangement was defined as >15% of tumor cells showing split signals or lone 3´ (orange color) signals (Fig. 1).


Analysis of Histologic Features Suspecting Anaplastic Lymphoma Kinase (ALK)-Expressing Pulmonary Adenocarcinoma.

Choi IH, Kim DW, Ha SY, Choi YL, Lee HJ, Han J - J Pathol Transl Med (2015)

Fluorescence in situ hybridization (FISH) of anaplastic lymphoma kinase (ALK)-rearranged pulmonary adenocarcinoma. Rearranged tumor nuclei show split signals (arrows) of 3´ (orange color) and 5´ (green color) ends of the gene hybridized using a dualcolor ALK break-apart FISH probe (Vysis LSI ALK Dual Color, Break Apart Rearrangement Probe, Abbott Molecular).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508568&req=5

f1-jptm-49-4-310: Fluorescence in situ hybridization (FISH) of anaplastic lymphoma kinase (ALK)-rearranged pulmonary adenocarcinoma. Rearranged tumor nuclei show split signals (arrows) of 3´ (orange color) and 5´ (green color) ends of the gene hybridized using a dualcolor ALK break-apart FISH probe (Vysis LSI ALK Dual Color, Break Apart Rearrangement Probe, Abbott Molecular).
Mentions: The FISH analysis for ALK rearrangement on FFPE tissue was examined using a probe specific to the ALK locus (Vysis LSI ALK dual-color, Break-Apart Rearrangement Probe, Abbott Molecular, Abbott Park, IL, USA). At least 50 nonoverlapping tumor cells were examined, and the cut-off value for positive ALK rearrangement was defined as >15% of tumor cells showing split signals or lone 3´ (orange color) signals (Fig. 1).

Bottom Line: However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation.Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer.In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Since 2007 when anaplastic lymphoma kinase (ALK) rearrangements were discovered in non-small cell lung cancer, the ALK gene has received attention due to ALK-targeted therapy, and a notable treatment advantage has been observed in patients harboring the EML4/ALK translocation. However, using ALK-fluorescence in situ hybridization (FISH) as the standard method has demerits such as high cost, a time-consuming process, dependency on interpretation skill, and tissue preparation. We analyzed the histologic findings which could complement the limitation of ALK-FISH test for pulmonary adenocarcinoma.

Methods: Two hundred five cases of ALK-positive and 101 of ALK-negative pulmonary adenocarcinoma from January 2007 to May 2013 were enrolled in this study. The histologic findings and ALK immunohistochemistry results were reviewed and compared with the results of ALK-FISH and EGFR/KRAS mutation status.

Results: Acinar, cribriform, and solid growth patterns, extracellular and intracellular mucin production, and presence of signet-ring-cell element, and psammoma body were significantly more often present in ALK-positive cancer. In addition, the presence of goblet cell-like cells and presence of nuclear inclusion and groove resembling papillary thyroid carcinoma were common in the ALK-positive group.

Conclusions: The above histologic parameters can be helpful in predicting ALK rearranged pulmonary adenocarcinoma, leading to rapid FISH analysis and timely treatment.

No MeSH data available.


Related in: MedlinePlus