免疫组化法检测EML4-ALK融合突变价值的meta分析

BACKGROUND AND OBJECTIVE: Te fusion between echinoderm microtubule-associated protein 4 (EML4) and anaplastic lymphatic tumor kinase (ALK) rearrangement is present in approximately 5% of non-small cell lung cancer (NSCLC) patients. It has been regarded as another new target gene afer epidermal growth factor receptor (EGFR) and K-ras. Figures showed that the disease control rate could reach up to 80% in NSCLC patients with EML4-ALK fusion gene afer treated with ALK inhibitors. Tus, exploring an accurate and rapid detecting method is the key in screening NSCLC patients with EML4-ALK expressions. Te aim of this study is to analyze the specifcity and sensitivity of IHC in detecting EML4-ALK fusion mutations. To evaluate the accuracy and clinical value of this method, and then provide basis for individual molecular therapy of NSCLC patients. METHODS: Using Pubmed database to search all documents required. Te deadline of retrieval was February 25, 2015. Ten further screening the articles according to the inclusion and exclusion criteria. Using diagnostic test meta-analysis methods to analyze the sensitivity and specifcity of the immunohistochemistry (IHC) method compared with fluorescence in situ hybridization (FISH) method. RESULTS: Eleven literatures were added into the meta analysis, there were 3, 234 of total cases. Te diagnositic odds ratio (DOR) was 1, 135.00 (95%CI: 337.10-3, 821.46); the area under curve (AUC) of summary receiver operating characteristic curve (SROC) curve was 0.992, 3 (SEAUC=0.003, 2), the Q(*) was 0.964, 4 (SEQ(*)=0.008, 7). CONCLUSION: Immunohistochemical detection of EML4-ALK fusion gene mutation with specifc antibody is feasible. It has high sensitivity and specifcity. IHC can be a simple and rapid way in screening EML4-ALK fusion gene mutation and exhibits important clinical values.