The Research Of Clinical Analyses Of ALK-positive Non-small Cell Lung Cancer(NSCLC) In 36

Objective: To investigate the incidence of enchinoderm microtubule associated protein like 4 anaplastic lymphoma kinase(EML4-ALK) positive non-small cell lung cancer(NSCLC), and the aim of this study is to analysis the clinical pathological features of ALK positive NSCLC, meanwhile, learning the correlation between large samples and small samples in the diagnosis of ALK positive NSCLC. This study is to investigate the phenomenon of detecting ALK fusion gene mutation and EGFR mutation coexist.Methods: Collecting clinical data of NSCLC patients who were diagnosed with lung cancer by cytology and pathology in First Affiliated Hospital, Soochow University from February 2014 to November 2014 were analyzed retrospectively, 36 NSCLC cases were confirmed with ALK expression. Ventana ALK(D5F3) rabbit monoclonal antibody that Ventana ALK immunohistochemistry(IHC) to detect ALK expression.Results: Collected the information of 453 NSCLC cases who were underwent genetic testing of EML4-ALK, however, clinical data were incomplete and lost in 51 cases, so they were excluded. This study is to analysis the remaining 402 cases of pathological specimens. 1.The positive incidence of ALK by Ventana ALK IHC was 8.96%(36/402). 2.There was statistical difference between ALK expression and age, smoking history, pathologic type(P<0.05). The incidence of ALK-positive NSCLC whose age was less than or equal to 65 was significantly higher than those whose age was more than 65. The incidence of ALK-positive NSCLC who had no smoking history was significantly higher than that of smokers. ALK fusion gene positive NSCLC was more expressed in adenocarcinoma and glandular squamous cell than in lung squamous cell carcinoma or other types. 71 cases of squamous cell carcinoma patients were not detected ALK expression. 3.There was no statistical difference between ALK expression and gender, stage, the source of sample, serum tumor markers(CA125, CEA, CYFRA211, CA72-4, NSE)(P>0.05). 4.There were 3 cases of ALK fusion gene mutation and EGFR mutation coexist.Conclusion:1.Ventana ALK IHC as reliable and inexpensive detection method, can be used as a means of clinical screeningin allhospitals.2.Through the analysis of 402 cases of NSCLC patients, it is confirmed that ALK fusion gene expression tended to express in young, non-smoking, adenocarcinoma, and glandular squamous cell.3.ALK fusion gene mutation and EGFR mutation coexit,but have different efficacy to EGFR-TKI and ALK inhibitors.