Abstract
Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized. Many controversial data have been reported on the adequacy of cytology cell blocks (CBs) versus conventional smears for FISH testing. This review discusses some critical issues related to ALK FISH of cytological samples, including the triaging of collected specimens to optimize the material, the use of CBs versus conventional smears, and alternative methods for an ALK rearrangement diagnosis. Conventional smears have the advantages of an immediate evaluation, no probe tissue-related artifactual loss, no fixation-related alterations, and usually sufficient material for an analytic preparation. On the other hand, CBs have several advantages, including the appropriate conservation of the tissue architecture, an absence of problems related to cell overlapping, and the ability to evaluate neoplastic cells in a dark field.
| Original language | English |
|---|---|
| Journal | Cancer cytopathology |
| DOIs | |
| Publication status | Published - May 2017 |
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Keywords
- Anaplastic lymphoma kinase (ALK)
- Cell block
- Cytological smears
- Fluorescence in situ hybridization (FISH)
- Lung cytology
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
Diagnosis of anaplastic lymphoma kinase rearrangement in cytological samples through a fluorescence in situ hybridization-based assay : Cytological smears versus cell blocks. / Zito Marino, Federica; Rossi, Giulio; Brunelli, Matteo; Malzone, Maria Gabriella; Liguori, Giuseppina; Bogina, Giuseppe; Morabito, Alessandro; Rocco, Gaetano; Franco, Renato; Botti, Gerardo.
In: Cancer cytopathology, 05.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnosis of anaplastic lymphoma kinase rearrangement in cytological samples through a fluorescence in situ hybridization-based assay
T2 - Cytological smears versus cell blocks
AU - Zito Marino, Federica
AU - Rossi, Giulio
AU - Brunelli, Matteo
AU - Malzone, Maria Gabriella
AU - Liguori, Giuseppina
AU - Bogina, Giuseppe
AU - Morabito, Alessandro
AU - Rocco, Gaetano
AU - Franco, Renato
AU - Botti, Gerardo
PY - 2017/5
Y1 - 2017/5
N2 - Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized. Many controversial data have been reported on the adequacy of cytology cell blocks (CBs) versus conventional smears for FISH testing. This review discusses some critical issues related to ALK FISH of cytological samples, including the triaging of collected specimens to optimize the material, the use of CBs versus conventional smears, and alternative methods for an ALK rearrangement diagnosis. Conventional smears have the advantages of an immediate evaluation, no probe tissue-related artifactual loss, no fixation-related alterations, and usually sufficient material for an analytic preparation. On the other hand, CBs have several advantages, including the appropriate conservation of the tissue architecture, an absence of problems related to cell overlapping, and the ability to evaluate neoplastic cells in a dark field.
AB - Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK-positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin-embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized. Many controversial data have been reported on the adequacy of cytology cell blocks (CBs) versus conventional smears for FISH testing. This review discusses some critical issues related to ALK FISH of cytological samples, including the triaging of collected specimens to optimize the material, the use of CBs versus conventional smears, and alternative methods for an ALK rearrangement diagnosis. Conventional smears have the advantages of an immediate evaluation, no probe tissue-related artifactual loss, no fixation-related alterations, and usually sufficient material for an analytic preparation. On the other hand, CBs have several advantages, including the appropriate conservation of the tissue architecture, an absence of problems related to cell overlapping, and the ability to evaluate neoplastic cells in a dark field.
KW - Anaplastic lymphoma kinase (ALK)
KW - Cell block
KW - Cytological smears
KW - Fluorescence in situ hybridization (FISH)
KW - Lung cytology
UR - http://www.scopus.com/inward/record.url?scp=85013196999&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013196999&partnerID=8YFLogxK
U2 - 10.1002/cncy.21835
DO - 10.1002/cncy.21835
M3 - Article
AN - SCOPUS:85013196999
JO - Cancer cytopathology
JF - Cancer cytopathology
SN - 1934-662X
ER -