High concordance between Immunohistochemistry and RT-PCR in diagnosing ALK rearrangement in lung adenocarcinoma cytologic samples.

Q3 Medicine
Medical Journal of Malaysia Pub Date : 2025-05-01
D S Heriyanto, L Rachmadi, I Trisnawati, J B Tenggara, R Cempaka, H Aribowo, Y Kurnia, V Lau, A N Gunawan, B N Halim, F S Yuliani, V Laiman, H C Chuang
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引用次数: 0

Abstract

Introduction: Lung cancer, predominantly lung adenocarcinoma, remains a major health challenge in Indonesia, with late-stage detection being common. This study explores the use of quantitative real-time polymerase chain reaction (qRT-PCR) for assessing ALK rearrangement from smear samples, a significant shift towards less invasive diagnostic methods, by assessing its concordance with immunohistochemistry (IHC) in detecting Anaplastic Lymphoma Kinase (ALK) rearrangements in lung adenocarcinoma patients.

Materials and methods: This observational cross-sectional study analyzed 175 lung adenocarcinoma samples lacking EGFR mutations collected between 2018 and 2022. IHC was performed with the Ventana ALK D5F3 clone antibody on cell blocks or core needle biopsy specimens. The EML4-ALK fusion rearrangement status was determined using quantitative RNA qRT-PCR analysis on the smear specimen from transthoracic needle aspiration (TTNA) from the same sample. Only specimens with viable tumor cells were included, ensuring the exclusion of metastatic or necrotic samples.

Results: ALK rearrangements were identified in 16.2% (23/142) of samples via IHC and 14.8% (21/142) via qRT-PCR. Prevalence did not significantly differ by age and sex. The study found a 98.5% concordance rate between the two methods, with a κ coefficient of 0.95 (95% CI, 0.91-0.98), indicating almost perfect agreement.

Conclusion: The high concordance between IHC and qRTPCR underscores their reliability in detecting ALK rearrangements, crucial for the precise diagnosis and treatment of lung adenocarcinoma in Indonesia. These findings support the use of either method, depending on available resources and expertise, to enhance lung cancer management.

免疫组化与RT-PCR诊断肺腺癌细胞学样本中ALK重排的一致性高。
肺癌,主要是肺腺癌,仍然是印度尼西亚的一个主要健康挑战,晚期检测很常见。本研究通过评估其与免疫组化(IHC)检测肺腺癌患者间变性淋巴瘤激酶(ALK)重排的一致性,探索了使用定量实时聚合酶链反应(qRT-PCR)来评估涂片样本中ALK重排的方法,这是向微创诊断方法的重大转变。材料和方法:本观察性横断面研究分析了2018年至2022年间收集的175例缺乏EGFR突变的肺腺癌样本。在细胞块或核心针活检标本上使用Ventana ALK D5F3克隆抗体进行免疫组化。对同一标本经胸穿刺涂片标本(TTNA)采用定量RNA qRT-PCR分析确定EML4-ALK融合重排状态。仅包括具有活肿瘤细胞的标本,以确保排除转移或坏死样本。结果:经免疫组化检测,ALK重排率为16.2% (23/142),qRT-PCR检测,ALK重排率为14.8%(21/142)。患病率在年龄和性别之间没有显著差异。研究发现两种方法的一致性为98.5%,κ系数为0.95 (95% CI, 0.91-0.98),几乎完全一致。结论:免疫组化与qRTPCR的高度一致性强调了它们在检测ALK重排方面的可靠性,这对于印度尼西亚肺腺癌的精确诊断和治疗至关重要。这些发现支持使用任何一种方法,取决于可用的资源和专业知识,以加强肺癌管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Journal of Malaysia
Medical Journal of Malaysia Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
165
期刊介绍: Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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