Are There Imaging Characteristics Associated with Epidermal Growth Factor Receptor and KRAS Mutations in Patients with Adenocarcinoma of the Lung with Bronchioloalveolar Features?
Are There Imaging Characteristics Associated with Epidermal Growth Factor Receptor and KRAS Mutations in Patients with Adenocarcinoma of the Lung with Bronchioloalveolar Features?
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DOI：
10.1097/jto.0b013e3181ce9a7a
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发表时间：
2010-03-01
影响因子：
20.4
通讯作者：
Ginsberg, Michelle S.
中科院分区：
文献类型：
--
作者：
Glynn, Catherine;Zakowski, Maureen F.;Ginsberg, Michelle S.
目的：为了确定任何特定的成像功能，计算机断层扫描（CT）的患者确诊腺癌与细支气管肺泡（ABAC）的功能和已知的表皮生长因子受体（EGFR）和KRAS mutations.Materials和方法：机构审查委员会批准获得这项回顾性研究。评估了64例组织学诊断为ABAC且已知EGFR或KRAS突变状态的患者的77个肺结节。其中，23例EGFR和KRAS突变均为阴性的患者用作对照组。评估病灶大小、边缘和密度（磨玻璃与实体）。统计分析采用双尾Fisher精确检验t检验进行多个不同的variable.Results：21（33%）的64例患者有EGFR突变，20（31%）的64例患者有KRAS突变，23（36%）都没有。在9例EGFR突变患者中，有10个结节伴磨玻璃样阴影（GGO），在9例KRAS突变患者中，有9个结节伴GGO。77个结节中有26个（34%）有一些GGO，其中12个（46%）完全是GGO。77个结核中有62个（81%）含有固体成分，其中还包括一些与GGO混合的成分。77个结节中有35个（45%）有支气管充气征。所有5个结节（100%）和高比例的细支气管肺泡癌（>75%）仅表现为GGO。CT上GGO的存在与EGFR突变（p = 0.44）或KRAS突变（p = 0.77）的存在无显著相关性。结论：在我们的ABAC患者样本中，与没有这些突变的对照组患者相比，没有特异性CT表现，这与EGFR突变或KRAS突变相关。
Purpose: To identify any particular imaging features on computed tomography (CT) in patients with confirmed adenocarcinoma with bronchioloalveolar (ABAC) features and known epidermal growth factor receptor (EGFR) and KRAS mutations.Materials and Methods: Institutional review board approval was obtained for this retrospective study. Seventy-seven pulmonary nodules in 64 patients with a histologic diagnosis of ABAC and known EGFR or KRAS mutation status were assessed. Of these, 23 patients who were negative for both EGFR and KRAS mutations were used as a control group. Lesion size, margins, and density (ground glass versus solid) were assessed. Statistical analysis using the two-tailed Fisher's exact test t test was performed with multiple different variables.Results: Twenty-one (33%) of 64 patients had EGFR mutations, 20 (31%) of 64 patients had a KRAS mutation, and 23 (36%) had neither. In nine patients with an EGFR mutation, there were 10 nodules with some ground glass opacity (GGO) and in nine patients with a KRAS mutation, there were nine nodules with some GGO. Twenty-six (34%) of the 77 nodules had some GGO, and 12 (46%) of these 26 nodules were entirely GGO. Sixty-two (81%) of the 77 nodules had some solid component, which also included some that were mixed with GGO. Thirty-five (45%) of 77 nodules had air bronchograms. All five nodules (100%) with a high percentage of bronchioloalveolar carcinoma (>75%) had the appearance of GGO only. The presence of GGO on CT was not significantly associated with the presence of an EGFR mutation (p = 0.44) or with the presence of a KRAS mutation (p = 0.77).Conclusions: In our sample of patients with ABAC, there was no specific CT appearance, which would correlate with either an EGFR mutation or a KRAS mutation, when compared with a control group of patients who did not have these mutations.