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CC BY-NC-ND 4.0 · South Asian J Cancer 2020; 9(02): 109-114
DOI: 10.1055/s-0040-1721191
Original Article: Lung Cancer

Discordance between Fluorescence In Situ Hybridization and Immunohistochemistry Analysis of Anaplastic Lymphoma Kinase Rearrangement in Indian Patients with Non-Small Cell Lung Cancer

Manish Kumar
1   Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Kishore Kumar
2   Department of Medical Oncology, Command Hospital Air Force, Bengaluru, Karnataka, India
,
Harinder Pal Singh
1   Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Suresh Nair
1   Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Amol Patel
1   Department of Medical Oncology, Army Hospital Research and Referral, New Delhi, India
,
Ashok Kumar
3   Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
,
Sneha Soni
4   Community Medicine, Rama Medical College, Hapur, Uttar Pradesh, India
› Author Affiliations Funding Nil.
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Abstract

Aims This study aims to evaluate the incidence of anaplastic lymphoma kinase (ALK) mutation in nonsmall cell lung cancer (NSCLC) incorporating fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) methods and to look for any discordance.

Methods We evaluated 101 samples obtained from an enriched cohort of NSCLCs patients from the Army Hospital Research and Referral, New Delhi, India, between November 2016 and November 2018. IHC was performed using the highly-sensitive D5F3 rabbit monoclonal primary antibody. FISH was performed with dual-color, break-apart probe (ZytoLight SPEC) on formalin-fixed, and paraffin-embedded tissue. Discordance between IHC and FISH for ALK rearrangements was evaluated. Pearson correlation coefficient (r) was performed to identify any association of ALK presence (by IHC and FISH) with smoking brain metastasis, programmed death-ligand (PD-L1) expression, pleural effusion, and histopathological subtype.

Results A total of 7.92% (8/101) cases tested by IHC and 9.9% (10/101) cases tested by FISH were positive for ALK rearrangement. Of 93 ALK IHC-negative cases, 4 were ALK FISH-positive, whereas of 91 ALK FISH-negative cases, 4 were ALK IHC-positive cases. The correlation analysis demonstrated no or very weak correlation in ALK mutations by IHC or FISH with smoking, brain metastasis, PD-L1 expression, pleural effusion, and histopathological examination, except a weak positive correlation (r = 0.33) observed between brain metastasis and ALK rearrangement identified by FISH.

Conclusions Our study demonstrated a somewhat similar incidence of ALK FISH-positive cases and ALK IHC-positive cases, though the incidence was numerically higher for ALK-FISH method.

Keywords

anaplastic lymphoma kinase rearrangement - fluorescence in situ hybridization - immunohistochemistry - non-small cell lung cancer


Publication History

Article published online:
14 December 2020

© 2020. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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