Objective To analyze the image characteristics of chest schwannoma in coincidence 18FFDG SPECT studies,and to evaluate its prospective diagnostic function on chest schwannoma.Methods Four cases confirmed as schwannoma by surgery and pathology were enrolled in this retrospective study.Enhanced CT and coincidence 18F-FDG SPECT studies were performed before surgery.Imaging characteristics for the diagnosis of chest schwannoma were summarized.Results Tumors were totally removed by surgery.The histological diagnosis of schwannoma was confirmed by pathological,HE and immunohistological staining examination (positivity for the S-100 protein and vimentin),including 1 case of malignant schwannoma and 3 cases of benign.Four cases all showed high uptake of 18F-FDG.The uptake in malignant schwannoma was much higher than that in benign schwannoma.Benign schwannomas were noninvasive masses and mainly showed compression symptoms,with obvious lobulation and distinct borders.Malignant schwannoma was invasive masses.Conclusions 18 F-FDG coincidence SPECT is of limited value as a prospective diagnostic imaging technique for the identification of benign schwannoma from malignant schwannoma.But it could play an important role in the staging,restaging,and post-therapy follow-up of schwannoma.

Objective To detect the presence of ROS1 fusion gene in pulmonary adenocarcinoma and its clinicopathologic parameters.Methods Fluorescence RT-PCR was used to detect the presence of ROS1 fusion gene in 369 surgical resection samples of pulmonary adenocarcinoma with known EGFR mutation status.The presence of ROS1 fusion gene in correlation with clinicopathologic features was analyzed.Sixteen positive and 20 negative samples by RT-PCR were further confirmed by direct sequencing.Results ROS1 fusion gene was detected in 16 of 369 lung adenocarcinoma samples (4.3%).The presence of ROS1 fusion gene was not correlated to gender, age, smoking history, tumor site, size, histological subtype, tumor differentiation, T staging, lymph node metastasis, TNM staging and EGFR mutation ( P>0.05).The frequency of ROS1 fusion gene was similar in female and male patients,4.4%(8/183) vs 4.3%(8/186) , P>0.05.The presence of ROS1 fusion gene in patients of ≤60 years of age was higher than that in patients of >60 years,5.1%(10/195) vs 3.4%(6/174), P>0.05.The rate of ROS1 fusion gene of non-smokers was a slight higher than that of smokers, 4.4% ( 14/318 ) vs 3.9%( 2/51 ) , P>0.05.Both positive and negative cases were confirmed by direct sequencing in all cases.Conclusions ROS1 fusion gene occurs more frequently in younger and non-smoking patients of pulmonary adenocarcinoma, and may coexist with EGFR mutations.ROS1 fusion gene seems to define a distinct subset of pulmonary adenocarcinoma.

Objective To study the expression of ALK protein in pulmonary adenocarcinoma as detected by Ventana immunohistochemistry, with correlation of clinicopathologic features. Methods Immunohistochemical study for ALK protein using Ventana ALK ( D5F3) kit was carried in 7 371 pulmonary adenocarcinoma samples.The clinicopathologic features were subsequently analyzed.Results ALK fusion protein was detected in 446 of the 7 371 lung adenocarcinoma samples studied ( 6.05%) .The ALK positivity rate in small biopsy samples was higher than that in surgical specimens [ 9.02% ( 153/1 696 ) versus 5.16%(293/5 675);P<0.01] .ALK fusion protein expression correlated with patient age, sample type and smoking history.ALK positivity rate in each age group increased with younger patient age.ALK positivity rate was 45.45%(10/22) in patients younger than 30 years old.The positivity rate of ALK fusion protein in adenocarcinoma in-situ, minimally invasive adenocarcinoma and invasive adenocarcinoma was 0, 0.48%(2/418) and 5.63% (291/5 165), respectively.The differences of ALK positivity rate amongst different subtypes had statistical significance ( P<0.01 ).Invasive mucinous adenocarcinoma had highest ALK positivity rate, followed by invasive adenocarcinoma with predominantly solid pattern.Conclusions ALK fusion protein is more often found in young patients with pulmonary adenocarcinoma, especially in those younger than 30 years old.ALK fusion protein is rarely expressed in early-stage pulmonary adenocarcinoma. Invasive mucinous adenocarcinoma and invasive adenocarcinoma with solid pattern have higher ALK positivity rate than other adenocarcinoma subtypes.

OBJECTIVETo detect the presence of ROS1 fusion gene in pulmonary adenocarcinoma and its clinicopathologic parameters.

METHODSFluorescence RT-PCR was used to detect the presence of ROS1 fusion gene in 369 surgical resection samples of pulmonary adenocarcinoma with known EGFR mutation status. The presence of ROS1 fusion gene in correlation with clinicopathologic features was analyzed. Sixteen positive and 20 negative samples by RT-PCR were further confirmed by direct sequencing.

RESULTSROS1 fusion gene was detected in 16 of 369 lung adenocarcinoma samples (4.3%). The presence of ROS1 fusion gene was not correlated to gender, age, smoking history, tumor site, size, histological subtype, tumor differentiation, T staging, lymph node metastasis, TNM staging and EGFR mutation (P > 0.05). The frequency of ROS1 fusion gene was similar in female and male patients, 4.4% (8/183) vs 4.3% (8/186), P > 0.05. The presence of ROS1 fusion gene in patients of ≤ 60 years of age was higher than that in patients of > 60 years, 5.1% (10/195) vs 3.4% (6/174), P > 0.05. The rate of ROS1 fusion gene of non-smokers was a slight higher than that of smokers, 4.4% (14/318) vs 3.9% (2/51), P > 0.05. Both positive and negative cases were confirmed by direct sequencing in all cases.

CONCLUSIONSROS1 fusion gene occurs more frequently in younger and non-smoking patients of pulmonary adenocarcinoma, and may coexist with EGFR mutations. ROS1 fusion gene seems to define a distinct subset of pulmonary adenocarcinoma.