Frequency of the eml4-alk trasnlocation in lung adenocarcinomas by the FİSH technique WİTT immunohistochemical ttf-1, napsin-a and İGFR-1 expression in lung adenocarcinomas and their relation to adenocarci?noma subtypes and clinical, prognostic parameters

In the 2011 year, with a multidisciplinary approach, formed by involvement oncologists, pathologists, radiologists, molecular biologists, and thoracic surgeons, `International Association for the Study of Lung Cancer (IASLC), The American Thoracic Society (ATC) and The European Respiratory Society (ERS)? (IASLC/ATC/ERS), for lung adenocarcinomas subtyping and reporting procedure, significant changes were made. In this study, 203 cases with a diagnosis, lung adenocarcinoma of the lung resection and 48 cases with a diagnosis, metastatic adenocarcinoma of the lung metastases were re-examined by evaluating according to new classification,who were diagnosed between July 2006 and April 2013, at the department of Pathology, Faculty of Medicine, Gazi University. In this study, in lung adenocarcinomas, were determined for the frequency of, TTF-1 and Napsin-A with IGFR-1 expression and EML4-ALK translocation which are have an impact on the pathogenesis of cancer. In this study, was found to be acinar dominant pattern is the most frequently pattern in the resection specimens, and solid dominant pattern is the most frequently pattern in metastasis specimens. TTF-1 and Napsin-A were more frequently positive for aciner, papillary and lepidic patterns which are more well-differentiated patterns according to solid and mucinous patterns which are more poorly differentiated patterns. (in order of p=0,036 ve p=0,005) TTF-1 and Napsin-A were shows more common staining in women than in men (in order of p=0,042 ve p=0,013). TTF-1 and Napsin-A staining ratio was decreasing, diameter of the tumor was grows (in order of p=0,005 ve p=0,000). The frequency of Napsin-A staining was increasing, level of lymph node involvement was increases (p=0,018). In metastasis cases, according to non-smoker patients, smoker patients show a higher incidence of Napsin-A staining, (p=0,009). IGFR-1 was more frequantly observed at the middle-and low-differentiated patterns, although not statistically significant positivity for the IGFR-1. In this study trasnlocation of the EML4-ALK ratio were detected %3,8, in lung adenocarcinomas. When we look at the clinical features of the cases with the translocation, the EML4-ALK trasnlocation was more frequantly in the solid dominant pattern, according to the aciner dominant pattern. Also, EML4-ALK positive cases was found had a larger tumor diameter, according to EML4-ALK negative cases, (p=0,037). In conclusion, EML-ALK translocation, for the provide benefit target treatment, is necessarily need to be explore, for patients. Showing the association, clinical and pathological features of the patients with the trasnlocation, may guide the selection of cases. There is no advantage in Napsin-A according to TTF-1. (p=0,000). We suggest that, additional study with the clinical information for the survay of the patients, will give more effective results for the investigation of effect on prognosis for IGFR-1.