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.
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.