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ALK Testing in Lung Adenocarcinoma: Technical Aspects to Improve FISH Evaluation in Daily Practice  Vittoria Martin, PhD, Barbara Bernasconi, PhD, Elisabetta.

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Presentation on theme: "ALK Testing in Lung Adenocarcinoma: Technical Aspects to Improve FISH Evaluation in Daily Practice  Vittoria Martin, PhD, Barbara Bernasconi, PhD, Elisabetta."— Presentation transcript:

1 ALK Testing in Lung Adenocarcinoma: Technical Aspects to Improve FISH Evaluation in Daily Practice 
Vittoria Martin, PhD, Barbara Bernasconi, PhD, Elisabetta Merlo, MD, Piera Balzarini, BD, William Vermi, MD, Alice Riva, BD, Anna Maria Chiaravalli, BD, Milo Frattini, PhD, Nora Sahnane, PhD, Fabio Facchetti, MD, Luca Mazzucchelli, MD, Fausto Sessa, MD, Maria Grazia Tibiletti, BD  Journal of Thoracic Oncology  Volume 10, Issue 4, Pages (April 2015) DOI: /JTO Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 ALK FISH pattern scoring system. A, Normal cells showing two ALK-fused signals (ALK_F); (B) ALK short split pattern (ALK_S); (C) ALK long split pattern (ALK_L); (D) ALK far-away split pattern (ALK_FA); (E) ALK-deleted split pattern (ALK_D). Cells positive for ALK rearrangement (ALK_R) are those showing short, long, far-away splits, and deleted patterns; (F) ALK polysomy. ALK, anaplastic lymphoma kinase; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 ALK_R cells distribution in lung ADCs (n = 232). ALK_R: ALK-rearranged cells (namely all cells with positive patterns, constituted by ALK_S+ALK_L+ALK_FA+ALK_D). ALK, anaplastic lymphoma kinase; ADC, adenocarcinoma. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

4 FIGURE 3 ALK FISH patterns distribution in ALK+ lung ADCs (n = 28). ALK_R: ALK-rearranged cells (namely all cells with positive patterns, constituted by ALK_S+ALK_L+ALK_FA+ALK_D); ALK_S: ALK+ cells with a short split; ALK_L: ALK+ cells with a long split; ALK_FA: ALK+ cells with a far-away split; ALK_D: ALK+ cells with a deleted pattern. ALK, anaplastic lymphoma kinase; ADC, adenocarcinoma; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

5 FIGURE 4 ALK FISH patterns distribution in ALK borderline lung ADCs (n = 23); ALK borderline patients have an ALK_R population in a range of 10–20% ALK_R: ALK-rearranged cells (namely all cells with positive patterns, constituted by ALK_S+ALK_L+ALK_FA+ALK_D); ALK_S: ALK+ cells with a short split; ALK_L: ALK+ cells with a long split; ALK_FA: ALK+ cells with a far-away split; ALK_D: ALK+ cells with a deleted pattern. ALK, anaplastic lymphoma kinase; ADC, adenocarcinoma; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

6 FIGURE 5 ALK FISH patterns distribution in ALK− controls (n = 48); here, the presence of ALK_R cells indicates that the background noise is assay related. ALK_R: ALK-rearranged cells (namely all cells with positive patterns, constituted by ALK_S+ALK_L+ALK_FA+ALK_D); ALK_S: ALK+ cells with a short split; ALK_L: ALK+ cells with a long split; ALK_FA: ALK+ cells with a far-away split; ALK_D: ALK+ cells with a deleted pattern. ALK, anaplastic lymphoma kinase; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

7 FIGURE 6 A–D, Photographic gallery of lung cancer cells carrying ALK FISH short split patterns. For each cell is reported the approximate measure of fused signals, single signals, and split length, realized by the Bioview Duet System. ALK, anaplastic lymphoma kinase; FISH, fluorescence in situ hybridization. Journal of Thoracic Oncology  , DOI: ( /JTO ) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

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