Study of neurotrophic factor receptor tyrosine kinase gene fusion in the precise treatment of wild-type gastrointestinal stromal tumor / 中华胃肠外科杂志

The neurotrophin receptor kinase (NTRK) gene encodes neurotrophic factor receptor tyrosine kinase (NTRK), which plays an important role in the development and function of the nervous system. NTRK gene fusion mutation results in the production of chimeric NTRK proteins, which have carcinogenic potential through constitutive activation or overexpression. NTRK gene fusion mutation can lead to a special type of wild type gastrointestinal stromal tumor (GIST), whose clinical manifestations and treatment are completely different from other types of GIST. This fusion mutation can be detected clinically by a variety of methods, including tumor DNA and RNA sequencing and immunohistochemical staining. In patients with NTRK fusion positive tumors, NTRK inhibitors such as larotrectinib and entrectinib have shown good antitumor efficacy, with clinical response rates as high as 75%. Therefore, there is a need to improve the recognition and detection of fuch patients and to improve their prognosis by individualized and precise treatment with TRK inhibitors.

CD9 predicts ETV6-RUNX1 in childhood B-cell precursor acute lymphoblastic leukemia

ABSTRACT Introduction: The ETV6-RUNX1 is a fusion gene associated with a good outcome in B-cell precursor lymphoblastic leukemia. Objective: This study aimed to re-evaluate the CD9 cellular expression by flow cytometry (FC) as a possible tool to predict the presence of ETV6-RUNX1. Method: Childhood B-cell precursor lymphoblastic leukemia cases were included (n = 186). The percentage of CD9-labeled cells and the median fluorescence intensity ratio were used for correlation with the molecular tests. Receiver Operating Characteristic curves were performed to determine the likelihood of the CD9 expression predicting ETV6-RUNX1. Results: The ETV6-RUNX1 was found in 44/186 (23.6%) cases. Data analysis revealed that the best cutoff for CD9 percentage was 64%, with an accuracy of 0.84, whereas the best cutoff for CD9 median fluorescence intensity ratio was 12.52, with an accuracy of 0.80. A strong association was observed between the level of CD9 expression and the presence of ETV6-RUNX1. Conclusion: These data confirm that the CD9 expression could be used for risk stratification in clinical practice.

FusionScan: accurate prediction of fusion genes from RNA-Seq data

Identification of fusion gene is of prominent importance in cancer research field because of their potential as carcinogenic drivers. RNA sequencing (RNA-Seq) data have been the most useful source for identification of fusion transcripts. Although a number of algorithms have been developed thus far, most programs produce too many false-positives, thus making experimental confirmation almost impossible. We still lack a reliable program that achieves high precision with reasonable recall rate. Here, we present FusionScan, a highly optimized tool for predicting fusion transcripts from RNA-Seq data. We specifically search for split reads composed of intact exons at the fusion boundaries. Using 269 known fusion cases as the reference, we have implemented various mapping and filtering strategies to remove false-positives without discarding genuine fusions. In the performance test using three cell line datasets with validated fusion cases (NCI-H660, K562, and MCF-7), FusionScan outperformed other existing programs by a considerable margin, achieving the precision and recall rates of 60% and 79%, respectively. Simulation test also demonstrated that FusionScan recovered most of true positives without producing an overwhelming number of false-positives regardless of sequencing depth and read length. The computation time was comparable to other leading tools. We also provide several curative means to help users investigate the details of fusion candidates easily. We believe that FusionScan would be a reliable, efficient and convenient program for detecting fusion transcripts that meet the requirements in the clinical and experimental community. FusionScan is freely available at http://fusionscan.ewha.ac.kr/.

Current Status for Anaplastic Lymphoma Kinase in Non-small Cell Lung Cancer / 中国肺癌杂志

The incidence of ALK gene rearrangement in non-small cell lung cancer (NSCLC) was about 3% to 5%. ALK gene inhibitors have made great breakthrough in recent years, significantly extending the survival period of patients with ALK(+) advanced NSCLC. But the majority of patients will be acquired drug resistance after treatment. This article has been explained separately from the ALK genetic background, the detection method, the treatment of the three generations of ALK inhibitors and the strategy after drug resistance. It is desire to have reference value and reference meaning for clinical work.
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Improvement of clavulanic acid production in Streptomyces clavuligerus F613-1 by using a claR-neo reporter strategy

Background: Streptomyces clavuligerus was the producer of clavulanic acid, claR, a pathway-specific transcriptional regulator in S. clavuligerus, positively regulates clavulanic acid biosynthesis. In this study, the promoter-less kanamycin resistance gene neo was fused with claR to obtain strain NEO from S. clavuligerus F613-1. The claR-neo fusion strain NEO was mutated using physical and chemical mutagens and then screened under high concentrations of kanamycin for high-yield producers of clavulanic acid. Results: The reporter gene neo was fused downstream of claR and used as an indicator for expression levels of claR in strain NEO. After three rounds of continuous treatment and screening, the high-yield clavulanic acid-producing strain M3-19 was obtained. In the shaking flask model, the clavulanic acid titer of M3-19 reached 4.33 g/L, which is an increase of 33% over the titer of 3.26 g/L for the starting strains S. clavuligerus F613-1 and NEO. Conclusions: Our results indicate that neo can be effectively used as a reporter for the expression of late-stage biosynthetic genes when screening for high-yield strains and that this approach has strong potential for improving Streptomyces strains of industrial value.

Generation of dimeric single-chain antibodies neutralizing the cytolytic activity of vaginolysin

Background: Gardnerella vaginalis is a bacterial vaginosis (BV)-associated vaginal bacterium that produces the toxin vaginolysin (VLY). VLY is a pore-forming toxin that is suggested to be the main virulence factor of G. vaginalis. The high recurrence rate of BV and the emergence of antibiotic-resistant bacterial species demonstrate the need for the development of recombinant antibodies as novel therapeutic agents for disease treatment. Single-chain variable fragments (scFvs) generated against VLY exhibited reduced efficacy to neutralize VLY activity compared to the respective full-length antibodies. To improve the properties of scFvs, monospecific dimeric scFvs were generated by the genetic fusion of two anti-VLY scFv molecules connected by an alpha-helix-forming peptide linker. Results: N-terminal hexahistidine-tagged dimeric scFvs were constructed and produced in Escherichia coli and purified using metal chelate affinity chromatography. Inhibition of VLY-mediated human erythrocyte lysis by dimeric and monomeric scFvs was detected by in vitro hemolytic assay. The circulating half-life of purified scFvs in the blood plasma of mice was determined by ELISA. Dimeric anti-VLY scFvs showed higher neutralizing potency and extended circulating half-life than parental monomeric scFv. Conclusions: The protein obtained by the genetic fusion of two anti-VLY scFvs into a dimeric molecule exhibited improved properties in comparison with monomeric scFv. This new recombinant antibody might implement new possibilities for the prophylaxis and treatment of the diseases caused by the bacteria G. vaginalis.

Genetic Alterations and Their Clinical Implications in High-Recurrence Risk Papillary Thyroid Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Papillary thyroid carcinomas (PTCs) frequently involve genetic alterations. The objective of this study was to investigate genetic alterations and further explore the relationships between these genetic alterations and clinicopathological characteristics in a high-recurrence risk (node positive, N1) PTC group. MATERIALS AND METHODS: Tumor tissue blocks were obtained from 240 surgically resected patients with histologically confirmed stage III/IV (pT3/4 or N1) PTCs. We screened gene fusions using NanoString’s nCounter technology and mutational analysis was performed by direct DNA sequencing. Data describing the clinicopathological characteristics and clinical courses were retrospectively collected. RESULTS: Of the 240 PTC patients, 207 (86.3%) had at least one genetic alteration, including BRAF mutation in 190 patients (79.2%), PIK3CA mutation in 25 patients (10.4%), NTRK1/3 fusion in six patients (2.5%), and RET fusion in 24 patients (10.0%). Concomitant presence of more than two genetic alterations was seen in 36 patients (15%). PTCs harboring BRAF mutation were associated with RET wild-type expression (p=0.001). RET fusion genes have been found to occur with significantly higher frequency in N1b stage patients (p=0.003) or groups of patients aged 45 years or older (p=0.031); however, no significant correlation was found between other genetic alterations. There was no trend toward favorable recurrence-free survival or overall survival among patients lacking genetic alterations. CONCLUSION: In the selected high-recurrence risk PTC group, most patients had more than one genetic alteration. However, these known alterations could not entirely account for clinicopathological features of high-recurrence risk PTC.

Expression of MLAA34-HSP70 fusion gene constructed by SOE-PCR

To construct the pIRES2-MLAA34-HSP70 recombinant vector and express the MLAA34-HSP70 recombinant proteins in Escherichia coli [E. coli]. The MLAA34 and the HSP70 genes were extracted from U937 cells by RT-PCR, and then we amplified the fusion gene MLAA34-HSP70 by SOE-PCR and inserted it into the pIRES2-EGFP vector to construct the pIRES2-MLAA34-HSP70 recombinant vector. We amplified the fusion gene MLAA34-HSP70 successfully and identified the correctness of pIRES2-MLAA34-HSP70 recombinant vector by PCR and restriction endonuclease. Moreover, the MLAA34-HSP70 recombinant proteins expressed in E. coli were consistent with the expected molecular weight. We constructed the pIRES2-MLAA34-HSP70 recombinant vector successfully and the MLAA34-HSP70 recombinant proteins were successfully expressed by the induction of IPTG

Identificação e caracterização molecular de duas fusões gênicas recorrentes em leucemia mielóide aguda: ETV6-ANLN e NPM1-HAUS1 / Identification and molecular characterization of two recurrente gene fusions in acute myeloid leukemia: ETV6-ANLN and NPM1-HAUS1

Leucemia Mielóide Aguda (LMA) é uma neoplasia hematológica associada a alta morbidade e mortalidade. Os mecanismos genômicos causadores da LMA são diversos e incluem mutações em ponto, inserções, deleções, alterações do número de cópias, na metilação e translocações cromossômicas. Enquanto os genes envolvidos nas translocações cromossômicas mais frequentemente encontradas em LMA já tenham sido identificados, ainda existem dezenas de translocações cromossômicas recorrentes cujos genes envolvidos nos pontos de quebra cromossômicos não são conhecidos. Esta identificação é essencial para a melhor compreensão dos mecanismos da leucemogênese e muitas vezes podem ter um impacto clínico, modificando a estratificação prognóstica ou a conduta terapêutica. No presente trabalho, através da técnica de sequenciamento de DNA de nova geração, identificamos os genes envolvidos em duas translocações cromossômicas recorrentes em LMA: t(7;12)(p15:p13) e t(5;18)(q35;q21) que levam aos genes de fusão ETV6-ANLN e NPM1-HAUS1 respectivamente. A fusão ETV6-ANLN justapõe o exon 1 do gene ETV6 aos exons 2 a 25 do gene ANLN, gerando uma proteína bastante similar ao ANLN selvagem. Esta fusão gênica é expressa em precursores hematopoiéticos CD34+ e nas linhagens granulocítica e linfoide T, tendo provavelmente ocorrido em uma célula tronco hematopoiética ou em um precursor comum linfóide e mielóide. A fusão NPM1-HAUS1 justapõe os exons 1 a 11 do gene NPM1 ao exon 9 do gene HAUS1, gerando uma proteína similar ao NPM1, porém com a presença de um sinal de exportação nuclear na porção C-terminal da proteína. Como consequência, a proteína híbrida NPM1-HAUS1 localiza-se no núcleo e no citoplasma, ao contrário da NPM1 selvagem que tem localização exclusivamente nuclear. Como a localização citoplasmática da proteína NPM1 é leucemogênica em outros contextos, esse é provavelmente o mecanismo leucemogênico inicial associado a esta translocação cromossômica. Em conclusão, nós identificamos e caracterizamos duas novas fusões gênicas recorrentes em LMA. (AU)

Acute Myeloid Leukemia (AML) is a neoplastic myeloid disease characterized by progressive substitution of normal hematopoiesis by leukemic blasts that is associated with high morbidity and mortality. AML is a genomic disease caused by distinct genomic mechanisms such as single nucleotide substitutions, insertions, deletions, copy number variations and chromosomal translocations. While the genes involved in common chromosomal translocations have been well studied, there are several recurrent chromosomal translocations for which the affected genes have not been characterized. The identifications of such genes is essential for better understanding of AML pathophysiology and has the potential to improve diagnostic, prognostic and the therapeutic approach of patients harboring such chromosomal translocations. In the present study we have identified the genes involved in two recurring chromosomal translocations in AML by means of next generation DNA sequencing: t(7;12)(p15:p13) and t(5;18)(q35;q21) that lead to the gene fusions ETV6-ANLN and NPM1-HAUS1 respectively. The gene fusion ETV6-ANLN juxtaposes ETV6 exon 1 to ANLN exons 2 to 25, culminating with a putative protein highly similar to wild type ANLN. This gene fusion is expressed in hematopoietic precursors, granulocytes and T cell lymphocytes, probably occurring in a hematopoietic stem cell or a common myeloid lymphoid precursor. The gene fusion NPM1-HAUS1 leads to the fusion of NPM1 exons 1 to 11 to HAUS1 exon 9, generetaing a putative protein similar to wild type NPM1 with the addition of a novel nuclear export signal (NES) in the C-terminal region of the protein. Regarding subcellular localization, NPM1-HAUS1 localizes in the nucleus and cytoplasm in opposition to wild type NPM1 that localizes exclusively in the nucleus. Since NPM1 cytoplasmic localization has been shown to be associated with leukemogenesis, this is probably the neoplastic mechanism associated with this gene fusion. In conclusion, we have described and characterized two novel gene fusions associated with recurrent chromosomal translocations in AML. (AU)

Alveolar soft part sarcoma: a clinicopathologic analysis of 48 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of alveolar soft part sarcoma (ASPS).</p><p><b>METHODS</b>The clinical data and pathologic features of 48 cases of ASPS were evaluated. Immunohistochemical study, PAS staining and fluorescence in-situ hybridization (FISH) were carried out in selected examples. Relevant literature was reviewed.</p><p><b>RESULTS</b>Amongst the 48 cases studied, there were 17 males and 31 females, with male-to-female ratio of 1.0∶1.8. The age of patients ranged from 2 to 60 years (median=26 years). The tumor was most commonly located in deep soft tissue, especially that of lower extremities. Histologically, the tumor cells were arranged in alveolar or solid patterns and separated by sinusoidal vessels. They were large and contained abundant eosinophilic granules or crystals in cytoplasm. The nuclei were round to polygonal and vesicular, often with prominent nucleoli. Intravascular tumor extension was common. Some cases showed necrosis, hemorrhage and cystic changes. Immunohistochemical study showed that the tumor cells were positive for TFE3 (100%, 33/33). FISH assay was carried out in 4 cases and all of them had TFE3-ASPL gene fusion.</p><p><b>CONCLUSIONS</b>ASPS is a rare malignant neoplasm, often occurs in young patients. TFE3 is a useful immunohistochemical marker for diagnosis. The diagnosis is further confirmed by other markers.</p>

Meningeal Solitary Fibrous Tumors with Delayed Extracranial Metastasis

BACKGROUND: The term solitary fibrous tumor (SFT) is preferred over meningeal hemangiopericytoma (HPC), because NAB2-STAT6 gene fusion has been observed in both intracranial and extracranial HPCs. HPCs are now considered cellular variants of SFTs. METHODS: This study analyzes 19 patients with STAT6-confirmed SFTs, who were followed for over 11 years in a single institution. Ten patients (10/19, 56.2%) had extracranial metastases (metastatic group), while the remainder (9/19) did not (non-metastatic group). These two groups were compared clinicopathologically. RESULTS: In the metastatic group, the primary metastatic sites were the lungs (n = 6), bone (n = 4), and liver (n = 3). There was a mean lag time of 14.2 years between the diagnosis of the initial meningeal tumor to that of systemic metastasis. The median age at initial tumor onset was 37.1 years in the metastatic group and 52.5 in the non-metastatic group. The 10-year survival rates of the metastatic- and non-metastatic groups were 100% and 33%, respectively. The significant prognostic factors for poor outcomes on univariate analysis included advanced age (≥45 years) and large initial tumor size (≥5 cm). In contrast, the patients with higher tumor grade, high mitotic rate (≥5/10 high-power fields), high Ki-67 index (≥5%), and the presence of necrosis or CD34 positivity showed tendency of poor prognosis but these parameters were not statistically significant poor prognostic markers. CONCLUSIONS: Among patients with SFTs, younger patients (<45 years) experienced longer survival times and paradoxically had more frequent extracranial metastases after long latent periods than did older patients. Therefore, young patients with SFTs require careful surveillance and follow-up for early detection of systemic metastases.

Identification of Alternative Splicing and Fusion Transcripts in Non-Small Cell Lung Cancer by RNA Sequencing / 결핵및호흡기질환

BACKGROUND: Lung cancer is the most common cause of cancer related death. Alterations in gene sequence, structure, and expression have an important role in the pathogenesis of lung cancer. Fusion genes and alternative splicing of cancer-related genes have the potential to be oncogenic. In the current study, we performed RNA-sequencing (RNA-seq) to investigate potential fusion genes and alternative splicing in non-small cell lung cancer. METHODS: RNA was isolated from lung tissues obtained from 86 subjects with lung cancer. The RNA samples from lung cancer and normal tissues were processed with RNA-seq using the HiSeq 2000 system. Fusion genes were evaluated using Defuse and ChimeraScan. Candidate fusion transcripts were validated by Sanger sequencing. Alternative splicing was analyzed using multivariate analysis of transcript sequencing and validated using quantitative real time polymerase chain reaction. RESULTS: RNA-seq data identified oncogenic fusion genes EML4-ALK and SLC34A2-ROS1 in three of 86 normal-cancer paired samples. Nine distinct fusion transcripts were selected using DeFuse and ChimeraScan; of which, four fusion transcripts were validated by Sanger sequencing. In 33 squamous cell carcinoma, 29 tumor specific skipped exon events and six mutually exclusive exon events were identified. ITGB4 and PYCR1 were top genes that showed significant tumor specific splice variants. CONCLUSION: In conclusion, RNA-seq data identified novel potential fusion transcripts and splice variants. Further evaluation of their functional significance in the pathogenesis of lung cancer is required.

Runx1-Runx1t1: comportamiento en pacientes con leucemia mieloide aguda en nuestro medio / Runx1-Runx1t1: behavior in patients with acute myeloid leukemia

El continuo desarrollo molecular ha restado protagonismo a otras clasificaciones de la leucemia mieloide aguda (LMA) basadas en la morfología e histoquímica general. En el caso de la LMA existe un subtipo donde el gen AML1 (RUNX1), esencial para la normal hematopoyesis, se fusiona con el gen co-represor transcripcional ETO (RUNX1T1) generando una proteína anormal con múltiples efectos en la mielopoyesis. Se analizó el comportamiento de este gen de fusión en 174 pacientes con LMA, estudiados por reacción en cadena de la polimerasa con reverso transcripción (RT-PCR) en el laboratorio de Biología Molecular del Instituto de Hematología e Inmunología (IHI) entre enero del 2000 y agosto del 2013. El 13,8 por ciento (24 pacientes) fue positivo al RUNX1-RUNX1T1. En dicho grupo la edad osciló entre los 3 y los 62 años, con una media de 20,9 años aunque la mayor incidencia fue en pacientes de edad pediátrica (1-19 años) con un 66,7 por ciento Predominó el sexo masculino y el color de la piel no blanca con 62,5 por ciento y 58,3 por ciento respectivamente. De estos pacientes, el 37,5 por ciento presentaron un diagnóstico morfológico de M2, el 12,5 por ciento de M4 y la mitad de los casos 50 por ciento habían tenido un diagnóstico al debut, sugestivo de leucemia promielocítica (LPM); a este último grupo se le determinó la presencia del gen quimérico PML/RARα, para los que fueron negativos, demostrándose posteriormente el RUNX1-RUNX1T1. En un solo paciente se encontró la asociación de la duplicación interna en tándem (DIT) del FLT3 con el RUNK1-RUNX1T1. La confirmación de la presencia del gen de fusión RUNX1-RUNX1T1 en pacientes con morfología M3, confirma una vez más que las técnicas moleculares son de vitales para el diagnóstico de la LMA y la morfología se va relegando a los casos donde la citogenética y la biología molecular a día de hoy no logren definir una alteración genética. Introducción: el continuo desarrollo molecular ha restado protagonismo a otras clasificaciones de la leucemia mieloide aguda (LMA) basadas en la morfología e histoquímica general. En el caso de la LMA existe un subtipo donde el gen AML1 (RUNX1), esencial para la hematopoyesis normal, se fusiona con el gen correpresor transcripcional ETO (RUNX1T1) nó el sexo masculino (62,5 por cientoy el color de la piel no blanca (58,3 por ciento). El 37,5 por ciento de los pacientes presentó diagnóstico morfológico de M2, el 12,5 por ciento de M4, y el 50 por ciento había tenido un diagnóstico al debut sugestivo de leucemia promielocítica; posteriormente se demostró el RUNX1 - RUNX1T1. En el 8,3 por ciento de los pacientes positivos al RUNX1 - RUNX1T1 se encontró asociación con la duplicación interna en tándem (DIT) del FLT3. Conclusiones: la presencia del gen de fusión RUNX1-RUNX1T1 en pacientes con morfología M3, confirma una vez más que las técnicas moleculares son de vital importancia para el diagnóstico de la LMA y la morfología se va relegando a los casos donde la citogenética y la biología molecular no logren definir una alteración genética(AU)

Introduction: the molecular development has reduced importance to other classifications of acute myeloid leukemia (AML) based on morphology and general histochemistry. When AML1 (RUNX1) gene, essential for normal hematopoiesis, is fused to the transcriptional co-repressor ETO (RUNX1T1) gene, an abnormal protein with multiple effects on myelopoiesis is synthesized. Objective: analyze the behavior of the fusion gene RUNX1 - RUNX1T1 in our patients. Methods: this fusion gene was evaluated in 174 patients with AML studied by polymerase chain reaction with reverse transcription (RT - PCR) at the laboratory of Molecular Biology of the Institute of Hematology and Immunology (IHI), between January 2002 and August 2013. Results: twenty four patients (13,8 percent) were positive to RUNX1-RUNX1T1. In this group age ranged from 3 to 62 years with a mean of 20.9 years, although the incidence was higher in pediatric patients (1 - 19 years), 66,7 percent. Males and non-white individuals were predominant with 62,5 percent and 58,3 percent respectively. Of these patients, 37,5 percent had a morphological diagnosis of AML M2; 12,5 percent of M4; and half of the patients (50 percent) had a diagnosis suggestive of promyelocytic leukemia (PML). In the latter group, the presence of the chimeric gene PML / RARα was determined; all these patients were negative for this fusion gene and later the RUNX1 - RUNX1T1 was demonstrated. The association of internal tandem duplication (ITD) - FLT3 with RUNK1 - RUNX1T1 was found in 8,3 percent. Conclusions: the fusion gene RUNX1 - RUNX1T1 in patients with morphological appearance of M3, once again confirms that molecular techniques are vital for the diagnosis of AML and morphology is relegated to cases where cytogenetic and molecular biology fails to define a genetic alteration(AU)

Transnational dialogues between specialist and institutional knowledge in occupational accident legislation, first half of the twentieth century / Diálogos transnacionales entre los saberes técnicos e institucionales en la legislación sobre accidentes de trabajo, primera mitad del siglo XX

In the early twentieth century, Argentina began legislating occupational safety. Law no.9.688 legislated accidents in the workplace (1915) and granted legal jurisdiction to work-related problems. The approval of this legislation was in dialogue with proposals being produced in other regions. The links established between local figures and colleagues elsewhere are useful for examining the circulation, reception and legitimation of knowledge on a regional scale. The objective of this article is to examine the transnational references in local discussions about occupational accidents in Peru and Chile during the first half of the twentieth century.

A partir del siglo XX, se inició en la Argentina la legislación protectora del trabajo. La ley n.9.688 legisló sobre accidentes de trabajo (1915) y otorgó jurisdicción legal a los problemas relativos al trabajo. La sanción de este corpus estuvo en diálogo con las propuestas que se producían en otras latitudes. Los vínculos que se establecieron entre los referentes locales y sus colegas son de utilidad para abordar el estudio de circulación, recepción y legitimación de los saberes dentro de una escala regional. Así pues, el objetivo de este trabajo es revisar las referencias transnacionales en las discusiones locales sobre los accidentes laborales en Perú y Chile durante la primera mitad del siglo XX.

Chloroplast localization of Cry1Ac and Cry2A protein- an alternative way of insect control in cotton

BACKGROUND: Insects have developed resistance against Bt-transgenic plants. A multi-barrier defense system to weaken their resistance development is now necessary. One such approach is to use fusion protein genes to increase resistance in plants by introducing more Bt genes in combination. The locating the target protein at the point of insect attack will be more effective. It will not mean that the non-green parts of the plants are free of toxic proteins, but it will inflict more damage on the insects because they are at maximum activity in the green parts of plants. RESULTS: Successful cloning was achieved by the amplification of Cry2A, Cry1Ac, and a transit peptide. The appropriate polymerase chain reaction amplification and digested products confirmed that Cry1Ac and Cry2A were successfully cloned in the correct orientation. The appearance of a blue color in sections of infiltrated leaves after 72 hours confirmed the successful expression of the construct in the plant expression system. The overall transformation efficiency was calculated to be 0.7%. The amplification of Cry1Ac-Cry2A and Tp2 showed the successful integration of target genes into the genome of cotton plants. A maximum of 0.673 µg/g tissue of Cry1Ac and 0.568 µg/g tissue of Cry2A was observed in transgenic plants. We obtained 100% mortality in the target insect after 72 hours of feeding the 2nd instar larvae with transgenic plants. The appearance of a yellow color in transgenic cross sections, while absent in the control, through phase contrast microscopy indicated chloroplast localization of the target protein. CONCLUSION: Locating the target protein at the point of insect attack increases insect mortality when compared with that of other transgenic plants. The results of this study will also be of great value from a biosafety point of view.

Manual immunohistochemistry for detecting ALK gene fusion antibody in 519 cases of non-small lung cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expression of anaplastic lymphoma kinase (ALK) gene fusion antibody in non-small cell lung cancer (NSCLC) and explore the clinicopathological significance.</p><p><b>METHODS</b>Using manual immunohistochemistry (IHC) with D5F3 rabbit monoclonal antibody, we detected the expression of ALK gene fusion protein in 519 cases of NSCLC. The relations of ALK fusion protein with the clinical characteristics of the patients and the histological classification of the tumors were analyzed. The expressions of ALK fusion protein were compared between surgical specimens and biopsy samples, and the consistency of manual IHC results was evaluated with the results of a fully automated IHC instrument and fluorescence in situ hybridization (FISH).</p><p><b>RESULTS</b>The positivity rate of ALK fusion protein was 11.37% (59/519) among the cases detected by manual IHC. The patients tended to have a young age of onset (P=0.048) and most of the tumors were adenocarcinoma. In the surgical specimens, ALK fusion protein was expressed mostly in invasive mucinous adenocarcinoma (P<0.01), and it was a high risk factor of lymph node metastasis [OR=2.188(95%C.I:1.161-4.122)]. No statistical difference was found in the test results of manual IHC between surgical specimens and biopsy samples. The results by manual IHC suggesting a strong expression were consistent with the results by automated IHC and FISH.</p><p><b>CONCLUSION</b>Manual IHC can be reliable for screening ALK fusion arrangement in patients with NSCLC.</p>

Detection of ALK, ROS1 and RET fusion genes in non-small cell lung cancer patients and its clinicopathologic correlation / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the prevalence of ALK, ROS1 and RET fusion genes in non-small cell lung cancer (NSCLC), and its correlation with clinicopathologic features.</p><p><b>METHODS</b>Formalin-fixed and paraffin-embedded tissue sections from samples of 302 patients with NSCLC were screened for ALK, ROS1, RET fusions by real-time polymerase chain reaction (PCR). All of the cases were validated by Sanger DNA sequencing. The relationship between ALK, ROS1, RET fusion genes and clinicopathologic features were analyzed.</p><p><b>RESULTS</b>In the cohort of 302 NSCLC samples, 3.97% (12/302) were found to contain ALK fusion genes, including 3 cases with E13; A20 gene fusion, 3 cases with E6; A20 gene fusion and 3 cases with E20; A20 gene fusion. There was no statistically significant difference in patient's gender, age, smoking history and histologic type. Moreover, in the 302 NSCLC samples studied, 3.97% (12/302) were found to contain ROS1 fusion genes, with CD74-ROS1 fusion identified in 9 cases. There was no statistically significant difference in patients' gender, age, smoking history and histologic type. One non-smoking elderly female patient with pulmonary adenocarcinoma had RET gene fusion. None of the cases studied had concurrent ALK, ROS1 and RET mutations.</p><p><b>CONCLUSIONS</b>The ALK, ROS1 and RET fusion gene mutation rates in NSCLC are low, they represent some specific molecular subtypes of NSCLC. Genetic testing has significant meaning to guide clinical targeted therapy.</p>

A standardized protocol for detection of ALK protein expression and gene fusion in lung adenocarcinoma cytologic specimens / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study was to establish a standardized protocol for detection of ALK protein expression and gene fusion in cytologic specimens.</p><p><b>METHODS</b>Lung adenocarcinoma cytologic specimens were collected from seven hospitals in Beijing city. A detection protocol for ALK protein expression and gene fusion was designed according to the results of comparative experiment. Ventana immunohistochemical (IHC) ALK(D5F3) detecting ALK protein expression was performed in 203 prepared formalin-fixed paraffin-embedded (FFPE) cell blocks. ALK gene fusion in 98 EGFR gene wild type cytologic specimens and in 4 bronchoalveolar lavage fluid (BL) samples was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). ALK gene fusion in the Ventana IHC ALK (D5F3) positive samples was further tested by fluorescence in situ hybridization (FISH). Six patients with ALK IHC-positive result were followed up to analyze the responses of crizotinib therapy. Comparative experiments: (1) Comparison of the results of 4% neutral buffered formalin fixed for different time (24 h, 48 h, 72 h) on the Ventana IHC ALK (D5F3) staining was conducted in two cases of IHC ALK positive FFPE cell blocks; (2) Comparing qRT-PCR results for ALK fusion in samples from FFPE cell blocks and cytospin prepared slides in 10 cases of lung adenocarcinoma cytologic specimens.</p><p><b>RESULTS</b>Among the specimens examined using the standardized protocol recommended by this study, 229 cases of cytologic specimens met the diagnostic criteria of lung adenocarcinoma. Among them, 207 cases obtained ALK gene test results (by at least one method), with an ALK test ratio of 90.4% (207/229). FFPE cell blocks were successfully prepared in 203 cases, Ventana IHC ALK (D5F3) were successfully performed in all the 203 FFPE cell blocks (100%), and the ALK protein positive detection rate was 10.3% (21/203). ALK fusion was tested in 98 FFPE cytologic samples of EGFR wild types by qRT-PCR, and 96 out of 98 (97.96%) cytologic samples were successfully performed.18 out of 19 IHC ALK-positive cases were verified to be of ALK fusion status by qRT-PCR. The concordance rate was 94.7% (Kappa=0.967, P<0.001) between Ventana IHC ALK (D5F3) and qRT-PCR, and the sensitivity of the Ventana IHC ALK (D5F3) assay compared with qRT-PCR was 100% and the specificity was 98.7%. FISH assay was used to verify the positive cases detected by Ventana IHC ALK (D5F3) staining. Two cases of low tumor cell content FFPE samples obtained indefinite results by FISH test. The six patients with positive ALK protein expression received crizotinib therapy, and 5 paitents got treated effectively. For two ALK IHC positive cases, which were 4% neutral buffered formalin fixed for 72 h, the result of Ventana IHC ALK (D5F3) staining became weakened obviously and uneven. In 10 cases of samples, total RNA was extracted from FFPE cytologic sections and cytospin prepared slides, and the results of qRT-PCR test and ALK gene fusion showed good concordance.</p><p><b>CONCLUSIONS</b>The standardized protocol recommended in this study expands the detection types and quantity of cytologic specimens for ALK protein expression and gene fusion and increased the detection rate. Ventana IHC ALK (D5F3) is a reliable method for detecting ALK protein expression in FFPE cell blocks. The pathologic quality control procedure prior to Ventana IHC ALK (D5F3) is crucial for the accuracy of testing the ALK gene status. When FFPE cell blocks could not be prepared or prepared unsuccessfully from the cytologic specimens, qRT-PCR may be an alternative option for the detection of ALK gene fusion.</p>

Renal cell carcinoma with t(6;11)(p21.2;q13)/MALAT1-TFEB fusion: a clinical and pathological analysis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype, differential diagnosis and prognosis of renal cell carcinoma (RCC) associated with t(6;11)(p21.2;q13)/MALAT1-TFEB gene fusion.</p><p><b>METHODS</b>A total of 9 cases of such rare tumor were selected for clinicopathologic, immunohistochemical and molecular analysis, with review of literature.</p><p><b>RESULTS</b>The age of the patients ranged from 21 to 42 years (mean=31.3 years). The patients included four men and five women. Histologically, 4 of the 9 cases studied showed classic morphologic features of TFEB RCC, with hyaline material, pigments and psammoma bodies frequently identified. The remaining 5 cases demonstrated uncommon morphology, mimicking perivascular epithelioid cell neoplasm, clear cell RCC, chromophobe RCC or papillary RCC. Immunohistochemical study showed that TFEB and vimentin were positive in all cases. Most of the tumors studied also expressed Ksp-cadherin, E-cadherin, CD117, HMB45, Melan A and Cathepsin K. CKpan showed immunostaining in only 1 case. The staining for TFE3, CD10 and CK7 were all negative. TFEB gene rearrangement was detected in all the 9 cases studied using fluorescence in-situ hybridization. MALAT1-TFEB fusion gene was identified in 2 cases by polymerase chain reaction and direct sequencing. TFEB RCC seemed to be an indolent tumor. During a mean follow-up of 31 months, none developed tumor recurrence, progression, or metastasis.</p><p><b>CONCLUSIONS</b>TFEB fusion-associated RCC is a rare neoplasm, tends to occur in young age group and carries an indolent behavior. Diagnosis relies on clinicopathologic findings and immunohistochemical analysis. TFEB break-apart FISH assay is a reliable tool in confirming the diagnosis.</p>

ALK gene fusion associated non-small cell lung cancer: automated immunostainer detection and clinicopathologic perspectives / 中华病理学杂志

To explore the automated immunostainer screening anaplastic lymphoma kinase (ALK) gene fusion non-small cell lung cancer (NSCLC) and clinicopathological characteristics of the molecular subtype lung cancers. Methods Five hundred and sixty-six cases of NSCLC were collected over a 16 month period. The test for ALK was performed by Ventana automated immunostainer with anti-ALK D5F3. The histological features, treatment and outcome of patients were assessed. Results Thirty-eight cases (6.7%, 38/566) of NSCLC showed ALK gene fusion. The frequency of ALK gene fusion was higher in male (7.1%, 25/350) than that in female (6.0%, 13/216) patients, but not achieving statistical significance (chi2 = 0.270, P = 0.604). ALK + NSCLC was more significantly more frequent in patients < or = 60 years (9.9%, 28/282) than >60 years (3.5% , 10/284) of age. Histologically, the ALK + NSCLCs were mostly adenocarcinoma (81.6%, 31/38) , among which eighteen cases were solid predominant subtype with mucin production; nine cases were acinar predominant subtype; one case was papillary predominant subtype and three cases were invasive mucinous adenocarcinoma. The ALK + non-adenocarcinoma included three cases of squamous cell carcinoma, three cases of adenosquamous carcinoma and one case of pleomorphic carcinoma. Among the ALK + NSCLC patients, the number of non/light cigarette smokers (86. 8% , 33/38) was more than that of heavy smokers. Twenty-nine cases were stages III and IV; twenty-nine cases showed lymph node metastasis; twenty cases showed metastases mostly to brain and bone; and one case showed EGFR gene mutation coexisting with ALK gene fusion. Twelve of fifteen patients received crizotinib therapy and remained stable. Conclusions NSCLC with ALK gene rearrangement shows distinctive clinical and histological features. Ventana-IHC may he a feasible and valid technique for detection of ALK rearrangement in NSCLC.