有关中国人非小细胞肺癌的驱动基因分布粗略调查
- 看过心中有个大致概念
EGFR - TK
41.0% (医科院) 分母 861 非小细胞肺癌
32.9% (天津医大) 301
36.7% (协和) 120
ALK - TK
4.84% (天津医大) 208
11.6% (广东人民医院) 103
9.7% (北医大) 113
4.0% (麻省一公司) 550
ALK 韩国人, 6%
ALK 日本人, 4-5%
KRAS
8.0% (医科院) 861
8.7% (协和) 120
4.7% (天津医大) 301
ROS1 - TK
2.0% (上海同济) 392
1.6% (麻省一公司) 550
RET - TK
1.5% (上海同济) 392
RET 日本人
1.1%
NTRK1 - TK
3.3% (这个最新发现的, 没有中国人数据)
BRAF
0.7% (医科院) 861
PIK3CA
3.7% (医科院) 861
2.4% (北医大) 123 鳞癌
ALK 检测目前还是有待完善 - 上面的%差别也与此有关
这个台湾成大医学院的详细报告有借鉴意义
简单的讲, FISH可能会漏掉真阳性, IHC可能会假阳性, RT-PCR比较适合用来做初筛选.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737393/
{
Results
Thirteen of the 312 patients (4.17%) had ALK rearrangements detected by RT-PCR. If RT-PCR data was used as the gold standard, FISH tests had a low sensitivity (58.33%), but very good specificity (99.32%). IHC stain had better sensitivity (91.67%) than FISH, but lower specificity (79.52%), when the cut off was IHC2+. All of the 8 patients with high abundance of EML4-ALK positive cells in tumor tissues (assessed by the signal intensities of the RT-PCR product), were also have high expression of ALK protein (IHC3+), and positive for FISH, except one failed in FISH. Variants 3a+3b (4/5, 80%) of EML4-ALK fusion gene were more common to have high abundance of EML4-ALK positive cells in tumor tissues than variant 1 (1/3, 33.3%). Meta-analysis of the published data of 2273 NSCLC patients revealed that variant 3 (23/44, 52.3%) was the most common type in Chinese population, while variant 1 (28/37, 75.7%) was most common in Caucasian.
Conclusions
Among the three detection methods, RT-PCR could detect not only the presence of EML4-ALK fusion gene and their variant types, but also the abundance of EML4-ALK positive cells in NSCLC tumor tissues. The latter two factors might affect the treatment response to anti-ALK inhibitor. Including RT-PCR as a diagnostic test for ALK inhibitor treatment in the prospective clinical trials is recommended.
} 貌似没有肾癌的 请教戴先生，知道有没有试过克药和二代ALk联合使用的情况，药理上有没有冲突，或者交替用药以延长耐药 快点上市吧，不知效果如何，有新消息的快上呵。:$
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