Epidermal growth factor receptor mutation accelerates radiographic progression in lung adenocarcinoma presented as a solitary ground-glass opacity
Epidermal growth factor receptor mutation accelerates radiographic progression in lung adenocarcinoma presented as a solitary ground-glass opacity
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表皮生长因子受体突变加速肺腺癌的放射学进展，表现为孤立的毛玻璃样混浊
DOI：
10.21037/jtd.2018.10.19
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发表时间：
2018-11-01
影响因子：
2.5
通讯作者：
Chen, Hezhong
中科院分区：
文献类型：
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作者：
Lu, Qijue;Ma, Ye;Chen, Hezhong
背景资料：我们旨在通过回顾性评估表皮生长因子受体（EGFR）突变状态与影像学特征之间的相关性，探讨EGFR突变在肺腺癌进展中的作用，并分析EGFR突变状态对肺腺癌进展的影响。方法：2013年至2015年，我们纳入了五十六例肺腺癌患者，均表现为孤立性磨玻璃样阴影（GGO）。每例患者均进行3次胸部CT扫描（术后第1次≥ 3个月，第2次= 3个月）。采用半自动算法测量每个病灶的直径和体积。结果：156例患者中，EGFR突变型75例（48.1%），其中外显子18、19和21突变型分别为1例、29例和45例。EGFR突变在女性（P=0.005）和非吸烟者（P=0.019）中更常见。75例EGFR突变患者术前1次和2次CT扫描比较显示，28例（37.3%）肿瘤大小增加超过50%，38例（52.0%）显示实性成分生长。81例无EGFR突变的乳腺癌中，有9例（11.1%）体积增大，14例（17.3%）成分凝固，明显低于EGFR突变组（P <0.01）。
Background: We aimed to investigate the impact of epidermal growth factor receptor (EGFR) mutation in the progression of lung adenocarcinoma presented as a solitary ground-glass opacity (GGO) by retrospectively evaluating the correlation between EGFR mutation status and the radiographic features.Methods: One hundred fifty-six cases of lung adenocarcinoma presented as a solitary GGO were enrolled between 2013 and 2015. Chest CT scans were performed 3 times (1st >= 3 months, 2nd = 3 months postoperatively) in each patient. The diameter and volume of every lesion was measured by semiautomated algorithm. EGFR mutation hotspots from exons 18, 19 and 21 were detected by real-time PCR.Results: In the 156 patients who were enrolled in our study, tumors in 75 patients (48.1%) were pathologically diagnosed with EGFR-mutant, with 1, 29 and 45 cases harboring tumors with mutation in exon 18, 19 and 21, respectively. EGFR mutation occurred more frequently in women (P=0.005) and nonsmokers (P=0.019). Comparison between the 1st and 2nd preoperative CT scans showed that 28 (37.3%) of 75 patients with EGFR mutations had an over 50% increment of tumor size and 38 (52.0%) displayed a growth of solid component. On the other hand, we found only 9 (11.1%) and 14 (17.3%) in 81 lesions without EGFR mutation had a distinct volume growth and component solidification, respectively, which is significantly less than that in EGFR mutation lesions (P