简介：Lungcanceristhemostfrequentlydiagnosedcancerandaleadingcauseofcancermortalityworldwide,withadenocarcinomabeingthemostcommonhistologicalsubtype.Deeperunderstandingofthepathobiologyofnon-smallcelllungcancer(NSCLC)hasledtothedevelopmentofsmallmoleculesthattargetgeneticmutationsknowntoplaycriticalrolesinprogressiontometastaticdiseaseandtoinfluenceresponsetotargetedtherapies.Theprinciplegoalofprecisionmedicineistodefinethosepatientpopulationsmostlikelytorespondtotargetedtherapies.However,thecancergenomelandscapeiscomposedofrelativelyfew"mountains"[representingthemostcommonlymutatedgeneslikeKRAS,epidermalgrowthfactor(EGFR),andanaplasticlymphomakinase(ALK)]andavastnumberof"hills"(representinglowfrequencybutpotentiallyactionablemutations).Low-frequencylesionsthataffectadruggablegeneproductallowarelativelysmallpopulationofcancerpatientsfortargetedtherapytobeselected.

简介：目的探讨间变性淋巴瘤激酶（anaplasticlymphomakinase,ALK）基因在肝细胞癌（hepatocellularcarcinoma,HCC）组织中的表达及其临床意义。方法采用荧光原位杂交法（fluorescentinsituhybridization,FISH）检测ALK在213例HCC组织中的表达,并分析其与患者临床病理特征及预后的相关性。结果213例HCC中无ALK基因重排阳性,28例存在ALK基因拷贝数增加（ALKgenecopynumbergain,ALK-CNG）现象。ALK-CNG阳性表达与HCC患者年龄。性别。AJCC分期。Child-Pugh评分及复发情况均无明显相关性（P〉0.05）,与HCC患者预后相关（P=0.048）,晚期患者中ALK-CNG阳性组与阴性组的无进展生存率差异有统计学意义（P=0.007）。单变量和多变量Cox回归分析显示,ALK-CNG阳性是HCC患者的独立预后预测指标（P=0.046）。结论HCC患者ALK基因重排阳性少见,但存在ALK基因拷贝数增加现象,且可能是影响HCC患者预后的不良因素。

简介：约半数的间变性大细胞淋巴瘤（ALCL）病人中存在间变性淋巴瘤激酶（ALK）基因异常，ALK蛋白的异常激活使ALK阳性ALCL具有其典型的临床病理特征，并为ALK阳性ALCL的治疗提供新的靶点，提示ALK阳性ALCL的淋巴瘤可归类为一独立病种。

简介：目的探讨非小细胞肺癌（NSCLC）中伴渐变性淋巴瘤激酶（ALK）蛋白阳性表达患者的临床病理特征。方法采用免疫组织化学技术检测141例NSCLC患者中ALK蛋白的表达情况,收集与分析伴ALK阳性表达患者的临床病理特征。结果免疫组织化学检测显示,NSCLC患者中ALK蛋白的阳性表达率为9.2%（13/141）。ALK阳性表达率在年龄、是否有表皮生长因子受体（EGFR）突变之间的差异均有统计学意义（P〈0.05）,而在性别、是否吸烟、是否饮酒、病理分型、原发部位、是否有甲状腺转录因子-1表达及有无淋巴结转移之间的差异无统计学意义（P〉0.05）。结论年轻（年龄≤57岁）、EGFR阴性的NSCLC患者是ALK突变的高发人群,建议此类患者进行ALK检测。

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简介：Duringthelastdecade,wehaveseentremendousprogressinthetherapyoflungcancer.DiscoveryofactionablemutationsinEGFRandtranslocationsinALKandROS1haveidentifiedsubsetsofpatientswithexcellenttumorresponsetooraltargetedagentswithmanageablesideeffects.Inthisreview,wehighlighttreatmentoptionsincludingcorrespondingclinicaltrialsforoncogenicalterationsaffectingthereceptortyrosinekinasesMET,FGFR,NTRK,RET,HER2,HER3,andHER4aswellascomponentsoftheRAS-RAF-MEKsignalingpathway.

简介：Non-smallcelllungcancer(NSCLC)ranksastheleadingcauseofcancer-relateddeathintheworld.Brainmetastasis(BM)isacommoncomplicationofNSCLC,with25%–40%ofpatientsdevelopingBMduringthecourseofthedisease.Asignificantstrategyoflocaldiseasecontrolinthecentralnervoussystemisradiationtherapy.Withthedevelopmentofprecisionmedicine,theconceptoftreatinglungcancerBMhasgraduallychanged.Inthiscase,weperformedasurgicalproceduretoobtainenoughtumortissueforthedetectionofthetargetgeneandotherrelatedexperimentsafterthepatientwasinformed.Finally,wefoundthatthepatienthadbothhepatocytegrowthfactorreceptor(MET)geneamplificationandkinesinlightchain1-anaplasticlymphomakinasefusion(KLC1-ALK)throughnext-generationsequencingandshowedsensitivitytothetargetedtherapyofcrizotinib.Thepatientexhibitedgoodresponse.Ourcasewassuccessfulandunderwenttargetedtherapywiththeguidanceofprecisediagnosis.

简介：目的：探讨1例具有明显浆细胞特征的骨原发ALK阳性的间变性大细胞淋巴瘤（anaplasticlargecelllymphoma,ALCL）的临床病理学特征及鉴别诊断要点。方法：收集1例原发于右股骨远端的具有明显浆细胞特征ALK阳性的间变性大细胞淋巴瘤临床及影像学资料、观察其病理学形态及免疫表型,并复习相关文献,探讨该肿瘤的病理诊断和鉴别诊断要点。结果：患者为16岁男性,因右膝关节疼痛6月,加重伴功能障碍3周入院。MRI显示：右股骨下段骨质及周围软组织可见团片状长T1长T2信号影,压脂呈高信号影,骨质呈明显破坏表现,增强扫描病灶呈明显不均匀强化。镜下观察可见：肿瘤由大小较一致的浆样细胞组成,细胞异型性明显,核分裂象多见,浸润周围骨组织。免疫组化示肿瘤细胞表达CD30、ALK-1、CD4、EMA及GramB（＋）。结论：骨原发性ALCL非常罕见,具有明显浆细胞特征的ALCL形态学特殊,明确诊断需结合组织病理学及免疫表型综合分析。