PT  - JOURNAL ARTICLE
AU  - Ryu Jokoji
AU  - Takashi Yamasaki
AU  - Seigo Minami
AU  - Kiyoshi Komuta
AU  - Yasushi Sakamaki
AU  - Kengo Takeuchi
AU  - Masahiko Tsujimoto
TI  - Combination of morphological feature analysis and immunohistochemistry is useful for screening of EML4-ALK-positive lung adenocarcinoma
AID  - 10.1136/jcp.2010.081166
DP  - 2010 Dec 01
TA  - Journal of Clinical Pathology
PG  - 1066--1070
VI  - 63
IP  - 12
4099  - http://jcp.bmj.com/content/63/12/1066.short
4100  - http://jcp.bmj.com/content/63/12/1066.full
SO  - J Clin Pathol2010 Dec 01; 63
AB  - Background A subset of lung cancers harbours the fusion gene echinoderm microtubule-associated protein-like-4–anaplastic lymphoma kinase (EML4-ALK). Recently, immunohistochemistry for ALK has shown sensitivity for the detection of EML4-ALK-positive lung adenocarcinoma almost equal to that of the fluorescence in situ hybridisation (FISH) assay.Aims To study the clinicopathological features of EML4-ALK-positive lung adenocarcinoma in a large number of surgically resected samples using immunohistochemistry, in order to establish a useful screening method for EML4-ALK-positive lung adenocarcinoma.Methods Immunohistochemistry for ALK was used to screen for EML4-ALK-positive lung adenocarcinomas in 254 cases of surgically resected samples.Results EML4-ALK-positive cases were detected in 3.1% of lung adenocarcinomas (8/254). EML4-ALK-positive lung adenocarcinomas showed significant associations with intra- and/or extra-cytoplasmic mucin (p=0.0001), and cribriform pattern with excessive extracytoplasmic mucin (p<0.0001). Signet-ring cell appearance alone lacked significance (p=0.149).Conclusion EML4-ALK-positive lung adenocarcinoma has a tendency to express a characteristic morphological pattern. The combined use of morphological feature analysis and immunohistochemistry may be a useful and cost effective screening method for EML4-ALK lung adenocarcinoma.