FDG Uptake in Non-Small Cell Lung Cancer Is Not an Independent Predictor of EGFR or KRAS Mutation Status A Retrospective Analysis of 206 Patients
FDG Uptake in Non-Small Cell Lung Cancer Is Not an Independent Predictor of EGFR or KRAS Mutation Status A Retrospective Analysis of 206 Patients
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DOI：
10.1097/rlu.0000000000000975
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发表时间：
2015-12-01
影响因子：
10.6
通讯作者：
Kim, Chun K.
中科院分区：
文献类型：
--
作者：
Lee, Seok Mo;Bae, Sang Kyun;Kim, Chun K.
目的 关于使用非小细胞肺癌 (NSCLC) 的 F-18-FDG 亲和力作为成像生物标志物来预测表皮生长因子受体 (EGFR) 突变状态的文献数据是相互矛盾的。 KRAS 突变与 PET/CT 上 NSCLC 的 FDG 亲和力之间的关联尚不清楚。我们通过进行几种不同的亚组分析来评估 NSCLC 中的 EGFR 或 KRAS 突变状态是否可以通过 FDG 亲合力来预测，以便更好地与各种已发表的结果进行比较。 患者和方法 在获得机构审查委员会批准后，我们招募了以下患者：(1) 进行 FDG PET/CT 进行 NSCLC 分期，(2) 已确定肿瘤的 EGFR 和 KRAS 突变状态，以及 (3) 没有不受控制的糖尿病。进行单变量和多变量回归分析以评估独立临床变量（性别、年龄、吸烟史、肿瘤组织学、肿瘤大小、分期和SUV衍生变量）与EGFR和KRAS突变状态之间的关系。对腺癌患者进行单独分析。 结果 206例患者（年龄33-88岁；男性148例/女性58例；曾经吸烟者71例/从不吸烟者135例；腺癌135例/鳞状细胞癌71例；I-II期22例/III-IV期184例；肿瘤大小1.2-15.0 cm；SUVmax， 2.9-36.4；EGFR 突变存在于 47 种；KRAS 突变存在于 20 种）。在多变量分析中，性别、吸烟史、组织学和肿瘤大小与 EGFR 突变显着相关，但 SUV 衍生的变量均不显着相关。同样，SUV 衍生变量与 KRAS 突变之间没有发现相关性。结论我们的结果表明 NSCLC 的 FDG 亲和力在预测 EGFR 或 KRAS 突变状态方面没有显着的临床价值。
Purpose Data in the literature regarding the use of F-18-FDG avidity of non-small cell lung cancer (NSCLC) as an imaging biomarker to predict the status of epidermal growth factor receptor (EGFR) mutation are conflicting. Association between KRAS mutation and FDG avidity of NSCLC on PET/CT is not well known. We assessed whether the EGFR or KRAS mutation status in NSCLC can be predicted by FDG avidity by performing several different subgroup analyses to better compare with various published results.Patients and Methods After obtaining institutional review board approval, we enrolled patients (1) who had FDG PET/CT performed for staging of NSCLC, (2) with EGFR and KRAS mutational status of tumor identified, and (3) without uncontrolled diabetes. Univariate and multivariate regression analyses were performed to assess the relationship between the independent clinical variables (sex, age, smoking history, tumor histology, tumor size, stage, and SUV-derived variables) and the EGFR and KRAS mutation status. Separate analyses were performed for patients with adenocarcinomas.Results There were 206 patients (age, 33-88 years; 148 male/58 female; 71 ever-smokers/135 never-smokers; 135 adenocarcinoma/71 squamous cell carcinoma; 22 stage I-II/184 stage III-IV; tumor size, 1.2-15.0 cm; SUVmax, 2.9-36.4; EGFR mutations present in 47; KRAS mutations present in 20). In multivariate analysis, sex, smoking history, histology, and tumor size were significantly associated with EGFR mutation but none of the SUV-derived variables was. Likewise, no correlation was found between the SUV-derived variables and KRAS mutation.Conclusions Our results suggest that FDG avidity of NSCLC has no significant clinical value in predicting the EGFR or KRAS mutation status.