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棘皮动物微管结合蛋白-间变性淋巴瘤激酶(echinoderm microtubule-associated prote i n-l ike4-anaplastic lymphoma kinase,EML4-ALK)在肺癌中已成为第二个最重要的驱动致癌基因,在4%~6%的肺腺癌中EML4-ALK已经成为第一个可以靶向治疗的融合基因位点。伴随着ALK分离探针荧光原位杂交(fluorescent in situ hybridization,FISH)试剂盒的上市,克唑替尼已经被批准治疗ALK阳性的进展期非小细胞肺癌(non-small cell lung cancer,NSCLC)。然而,一种靶向药物的成功主要取决于一种敏感且特异的筛选实验方法来检测分子药物作用的靶点。以作者的经验看,用RTPCR来检测EML4-ALK,比用FISH和免疫组化(immunohistochemistry,IHC)方法更敏感,结果更可靠。尽管通过FISH检测ALK已经经过大量的临床实验验证,然而该方法在技术层面仍存在许多具有挑战性的问题,而通过IHC和RT-PCR方法检测ALK仍需要临床进一步的探索。
Echinoderm microtubule-associated proteomicln4-anaplastic lymphoma kinase (EML4-ALK) has become the second most important driver oncogene in lung cancer, with a range of 4% to 6 EML4-ALK has been the first fusion gene site that can be targeted in lung adenocarcinomas. Crizotinib has been approved for the treatment of ALK-positive advanced non-small cell lung cancer (NSCLC) with the introduction of the ALK isolation probe fluorescence in situ hybridization (FISH) kit, . However, the success of a targeted drug depends largely on a sensitive and specific screening assay to detect the effects of molecular drugs. In the authors’ experience, the detection of EML4-ALK by RTPCR is more sensitive than FISH and immunohistochemistry (IHC) and results are more reliable. Although the detection of ALK by FISH has been verified by a large number of clinical trials, there are still many challenging technical problems in this method. However, further studies of ALK by IHC and RT-PCR are still needed.