免疫组化法检测EML4-ALK融合突变价值的meta分析

背景与目的棘皮动物微管相关蛋白4（echinoderm microtubule-associated protein 4,EML4）与间变性淋巴瘤激酶（anaplastic lymphatic tumor kinase,ALK）重排形成的融合基因存在于大约5%的非小细胞肺癌（non-small cell lung cancer,NSCLC）患者中,是继表皮生长因子受体（epidermal growth factor receptor,EGFR）、K-ras之后又一新型靶点基因。有数据显示携带EML4-ALK融合基因的NSCLC患者接受ALK抑制剂治疗后,其疾病控制的有效率可达80%,探索和建立...

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Bibliographic Details
Published in中国肺癌杂志 Vol. 19; no. 1; pp. 38 - 45
Main Author 刘畅 蔡璐 钟殿胜 王竞
Format Journal Article
LanguageChinese
Published 天津医科大学总医院肿瘤科,天津,300052%300052天津,天津医科大学总医院,天津市肺癌研究所 2016
Subjects
EML4-ALK
Meta分析
免疫组化
肺肿瘤
融合基因
EML4-ALK
Immunohistochemistry
融合基因
Meta analysis
Meta分析
肺肿瘤
免疫组化
Lung neoplasms
Fusion gene
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ISSN1009-3419
1999-6187
DOI10.3779/j.issn.1009-3419.2016.01.05

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Summary:背景与目的棘皮动物微管相关蛋白4（echinoderm microtubule-associated protein 4,EML4）与间变性淋巴瘤激酶（anaplastic lymphatic tumor kinase,ALK）重排形成的融合基因存在于大约5%的非小细胞肺癌（non-small cell lung cancer,NSCLC）患者中,是继表皮生长因子受体（epidermal growth factor receptor,EGFR）、K-ras之后又一新型靶点基因。有数据显示携带EML4-ALK融合基因的NSCLC患者接受ALK抑制剂治疗后,其疾病控制的有效率可达80%,探索和建立能够准确快速检测出NSCLC患者EML4-ALK融合突变的方法,是筛选出适合治疗的优势人群的关键。本研究分析免疫组化法（immunohistochemistry,IHC）检测EML4-ALK融合基因突变的敏感度与特异度,评价该方法准确性及临床应用价值,从而为肺癌患者＂个体化分子治疗＂提供依据。方法通过Pubmed数据库检索所有符合检索条件的文献,末次检索日期为2015年2月25日,根据纳入和排除标准进行进一步筛选,采用诊断试验meta分析方法,比较特异性抗体免疫组化法与＂金标准＂荧光原位杂交（fluorescence in situ hybridization,FISH）法的敏感度、特异度,以明确特异性抗体IHC作为筛查方法的可行性。结果本文11篇文献纳入meta分析,EML4-ALK融合基因免疫组化累计病例3,234例,诊断比值比（diagnositic odds ratio,DOR）为1,135.00（95%CI：337.10-3,821.46）;综合受试者工作特征曲线（summary receiver operating characteristic curve,SROC）下面积为0.992,3（SEAUC=0.003,2）,Q＊统计量为0.964,4（SEQ＊=0.008,7）。结论特异性抗体IHC法检测EML4-ALK融合基因的方法可行,具有高特异度和敏感度,可作为一种简单快速的筛查方法,具有临床应用价值。
Bibliography:Background and objective The fusion between echinoderm microtubule-associated protein 4（EML4） and anaplastic lymphatic tumor kinase（ALK） rearrangement is present in approximately 5% of non-small cell lung cancer（NSCLC） patients. It has been regarded as another new target gene after epidermal growth factor receptor（EGFR） and K-ras. Figures showed that the disease control rate could reach up to 80% in NSCLC patients with EML4-ALK fusion gene after treated with ALK inhibitors. Thus, exploring an accurate and rapid detecting method is the key in screening NSCLC patients with EML4-ALK expressions. The aim of this study is to analyze the specificity and sensitivity of IHC in detecting EML4-ALK fusion mutations. To evaluate the accuracy and clinical value of this method, and then provide basis for individual molecular therapy of NSCLC patients. Methods Using Pubmed database to search all documents required. The deadline of retrieval was February 25, 2015. Then further screening the articles according to the inclusio
ISSN:1009-3419
1999-6187
DOI:10.3779/j.issn.1009-3419.2016.01.05