Epidermal Growth Factor Receptor Mutation in Lung Adenocarcinomas: Relationship with CT Characteristics and Histologic Subtypes

被引：167

作者：

Lee, Hyun-Ju ^{[1
]}

Kim, Young Tae ^{[3
]}

Kang, Chang Hyun ^{[3
]}

Zhao, Binsheng ^{[5
]}

Tan, Yongqiang ^{[5
]}

Schwartz, Lawrence H. ^{[5
]}

Persigehl, Thorsten ^{[4
,5
]}

Jeon, Yoon Kyung ^{[2
]}

Chung, Doo Hyun ^{[2
]}

机构：

[1] Seoul Natl Univ Hosp, Dept Radiol, Seoul 110744, South Korea

[2] Seoul Natl Univ Hosp, Dept Pathol, Seoul 110744, South Korea

[3] Seoul Natl Univ, Coll Med,Clin Res Ctr, Dept Thorac & Cardiovasc Surg,Canc Res Inst, Seoul Natl Univ Hosp,Xenotransplantat Res Ctr, Seoul, South Korea

[4] Univ Hosp Munster, Dept Clin Radiol, Munster, Germany

[5] Columbia Univ, Med Ctr, Dept Radiol, New York, NY USA

来源：

RADIOLOGY | 2013年 / 268卷 / 01期

关键词：

GENE COPY NUMBER; GROUND-GLASS OPACITY; HIGH-RESOLUTION CT; THIN-SECTION CT; PULMONARY ADENOCARCINOMA; PERIPHERAL ADENOCARCINOMA; PROGNOSTIC IMPLICATIONS; GEFITINIB SENSITIVITY; PROTEIN EXPRESSION; EGFR MUTATIONS;

D O I：

10.1148/radiol.13112553

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

Purpose: To retrospectively identify quantitative computed tomographic (CT) features that correlate with epidermal growth factor receptor (EGFR) mutation in surgically resected lung adenocarcinomas stratified by the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS) classification in an East Asian cohort of patients known to have a high prevalence of EGFR mutations. Materials and Methods: An institutional review board approved this study and waived informed consent. In 153 surgically resected lung adenocarcinomas, EGFR mutation was determined by direct DNA sequencing. Histologic subtype was classified according to IASLC/ATS/ERS classification of lung adenocarcinoma. At preoperative chest CT, the percentage of ground-glass opacity (GGO) volume and total tumor volume of each tumor were measured by using a semiautomated algorithm. Distribution of EGFR mutation according to histologic subtype, percentage of GGO volume, and total tumor volume was evaluated by using the Fisher exact test, the Student t test, trend analysis, and multiple logistic regression analysis. Results: Exon 21 missense mutation was more frequent in lepidic predominant adenocarcinomas than in other histologic subtypes (odds ratio, 3.44; 95% confidence interval: 1.53, 7.74; P = .003). GGO volume percentage in tumors with exon 21 missense mutation (61.7% +/- 31.9 [standard deviation]) was significantly higher than that in EGFR wild-type tumors (30.0% +/- 38.5) (P = .0001) and exon 19-mutated tumors (28.9% +/- 37.7) (P = .0006). A significant trend of prevalence of exon 21 missense mutation increasing along with increasing GGO volume (P = .0008) was found. Conclusion: GGO volume percentage in tumors with exon 21 missense mutation was significantly higher than that in tumors with other EGFR mutation status. This can be related to the fact that exon 21 missense mutation was significantly more frequent in lepidic predominant adenocarcinomas, including adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant invasive adenocarcinoma, according to IASLE/ATS/ERS classification. (C) RSNA, 2013

引用

页码：254 / 264

页数：11

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