Differentiating synchronous double primary lung adenocarcinomas from intrapulmonary metastasis by CT features, EGFR mutations and ALK rearrangement status.
Differentiating synchronous double primary lung adenocarcinomas from intrapulmonary metastasis by CT features, EGFR mutations and ALK rearrangement status.
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DOI：
10.21037/jtd-19-3570
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发表时间：
2020-10
影响因子：
2.5
通讯作者：
Shi H
中科院分区：
文献类型：
--
作者：
Han X;Fan J;Liu T;Li N;Alwalid O;Gu J;Shi H
区分同时性双原发性肺腺癌 (SDPLA) 与肺间转移 (IPM) 具有重要的治疗和预后意义。这项回顾性研究旨在探讨计算机断层扫描 (CT) 特征和两种已知的致癌驱动突变 [表皮生长因子受体 (EGFR) 和间变性大细胞淋巴瘤激酶 (ALK)] 区分同步双原发性肺腺癌和伴有肺内转移的原发性肺腺癌的潜力。选取我院的SDPLA患者作为对照组，IPM患者作为对照组。所有 60 名患者（40 名 SDPLA 患者和 20 名 IPM 患者）均接受了 EGFR 突变和 ALK 状态检测，并在任何治疗前接受了胸部 CT 检查。独立样本学生t检验用于两组正态分布变量之间的比较，卡方检验用于比较分类变量。 SDPLA患者EGFR突变不一致率显着高于IPM患者（40% vs. 5%，P<0.001）。 ALK 阳性发生率为 15%，IPM 患者比 SDPLA 患者更可能出现 ALK 阳性（35% vs. 5%，P<0.001）。与IPM相比，SDPLA更常见于不同肺叶（P=0.024），淋巴结肿大较少（P=0.014），肿瘤间直径（äd）差异较小（P=0.001），更常见为分叶状肿瘤（P<0.001）、针状肿块（P<0.001）、磨玻璃影（GGO） （P=0.001）和空气支气管征（P=0.020）。与 IPM 患者相比，SDPLA 患者的 EGFR 突变表现出更高的一致性，并且 ALK 阳性的频率较低。因此，SDPLA 和 IPM 的 CT 特性显着不同。
Differentiating synchronous double primary lung adenocarcinoma (SDPLA) from interpulmonary metastasis (IPM) has significant therapeutic and prognostic implications. This retrospective study aimed to investigate the potential of computed tomography (CT) features and two known oncogenic driver mutations [epidermal growth factor receptor (EGFR) and anaplastic large-cell lymphoma kinase (ALK)] to discriminate synchronous double primary lung adenocarcinoma from one primary pulmonary adenocarcinoma with intrapulmonary metastasis. Patients with SDPLA were selected at our hospital, and those with IPM served as the control group. All 60 patients (40 with SDPLA and 20 with IPM) were tested for EGFR mutations and ALK status, and they underwent chest CT prior to any treatment. Independent-sample Student’s t-test was used for comparisons between two groups of normally distributed variables, and the Chi-square test was used to compare categorical variables. The discordance rate of EGFR mutations was significantly higher in patients with SDPLA than in patients with IPM (40% vs. 5%, P<0.001). The incidence of ALK-positive status was 15%, and patients with IPM were more likely to be ALK-positive than patients with SDPLA (35% vs. 5%, P<0.001). Compared to IPM, SDPLA more frequently occurred in different lobes (P=0.024), presented with less lymphadenopathy (P=0.014), showed a smaller difference in diameter (Äd) between tumors (P=0.001) and more commonly presented as lobulated tumors (P<0.001), spiculated masses (P<0.001), ground-glass opacities (GGOs) (P=0.001) and air bronchograms (P=0.020). Patients with SDPLA showed higher discordance with EGFR mutations and were less frequently ALK-positive than those with IPM. Thus, the CT characteristics are significantly different between SDPLA and IPM.
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DOI：
10.1097/pas.0b013e3181b8cf03
发表时间：
2009-12
期刊：
The American journal of surgical pathology
影响因子：
--
作者：
Girard N;Deshpande C;Lau C;Finley D;Rusch V;Pao W;Travis WD
通讯作者：
Travis WD
影响因子：
9.6
作者：
Shen, K. Robert;Meyers, Bryan F.;Jones, David R.
通讯作者：
Jones, David R.
影响因子：
158.5
作者：
Mok, Tony S.;Wu, Yi-Long;Fukuoka, Masahiro
通讯作者：
Fukuoka, Masahiro
影响因子：
158.5
作者：
Solomon, Benjamin J.;Mok, Tony;Waqar, S.
通讯作者：
Waqar, S.
影响因子：
19.7
作者：
Liu, Ying;Kim, Jongphil;Gillies, Robert J.
通讯作者：
Gillies, Robert J.