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| Application of pleural effusion wax block in the diagnosis of lung adenocarcinoma and detection of EGFR/ALK/ROS1 gene mutation |
| LIN Rixu1, LI Yida2, LIN Yi3, WANG Fang1, JIANG Lei4, LI Jianmin1. |
| 1.Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.The Second School of Medicine, Wenzhou Medical University, Wenzhou 325035, China; 3.Department of Pathology, the Affiliated Wenling Hospital of Wenzhou Medical University, Taizhou 317500, China; 4.Central Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China |
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| Cite this article: |
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LIN Rixu,LI Yida,LIN Yi, et al. Application of pleural effusion wax block in the diagnosis of lung adenocarcinoma and detection of EGFR/ALK/ROS1 gene mutation[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(2): 132-136,141.
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Abstract Objective: To explore the application value of pleural effusion cell block in the pathological diagnosis of lung adenocarcinoma and the detection of EGFR/ALK/ROS1 gene mutation. Methods: We selected pleural effusion cell blocks from 41 patients diagnosed with lung adenocarcinoma in the First Affiliated Hospital of Wenzhou Medical University from January 2017 to December 2021. The conventional cell smears and cell blocks were used for pathological HE staining, and NGS and ARMS methods were used for EGFR/ALK/ROS1 gene mutation detection, respectively. Results: The sensitivity of conventional smear was 90.2% and the false negative rate was 9.8%. The diagnostic sensitivity of pleural fluid cell blocks was 100%, and the false negative rate was 0. In the cell smears of malignant pleural effusion (MPE), the overall mutation rate of EGFR/ALK/ROS1 was 70.7% (29/41) and the EGFR mutation rate was 61.0% (25/41); ALK fusion gene detection rate was 7.3% (3/41); ROS1 fusion gene detection rate was 14.6% (6/41). In the cell blocks of MPE, the overall mutation rate of EGFR/ALK/ROS1 was 73.2% (30/41); the EGFR mutation rate was 68.3% (28/41); the ALK fusion gene detection rate was 2.4% (1/41); the ROS1 fusion gene detection rate was 4.9% (2/41). In addition, EGFR/ALK/ROS1 mutation-positive patients tested by both methods had increased overall survival rate, progression-free survival rate and disease control rate, compared with those without mutations. Conclusion: Compared with pleural effusion cell smear, pleural effusion cell block method has a higher positive detection rate, which can be used to guide
pathological diagnosis and molecular/genetic testing for targeted therapy.
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Received: 16 November 2022
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| [1] |
. [J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(9): 764-766,770. |
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