Comparative analysis of clinicoradiologic characteristics of lung adenocarcinomas with ALK rearrangements or EGFR mutations
Comparative analysis of clinicoradiologic characteristics of lung adenocarcinomas with ALK rearrangements or EGFR mutations
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DOI：
10.1007/s00330-014-3516-z
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发表时间：
2015-03-01
影响因子：
5.9
通讯作者：
Zhou, J. Y.
中科院分区：
文献类型：
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作者：
Zhou, J. Y.;Zheng, J.;Zhou, J. Y.
比较肺腺癌患者队列中棘皮动物间变性淋巴瘤激酶（ALK）重排、表皮生长因子受体（EGFR）突变或两种基因均为野生型（WT）的肿瘤的临床放射学特征，以确定不同基因状态的有用特征。在346例肺腺癌患者中，用荧光原位杂交证实ALK重排，用焦磷酸测序法测定EGFR突变。患者分为三组：ALK重排（ALK+组，n = 48）、EGFR突变（EGFR+组，n = 166）和两种基因的WT（WT组，n = 132）。所有患者均行胸部CT检查。使用半自动结节评估软件测量磨玻璃样阴影体积百分比（pGGO）和肿瘤阴影消失率（TDR），ALK+组的pGGO显著低于对照组，EGFR+组（37.2%+/-25.7，p < 0.001）和WT组（36.1%+/-24.6，p = 0.001）相比，EGFR+组（25.1%+/-24.3）中的细胞凋亡率更高。ALK+组的TDR（17.3% ± 25.1）显著低于EGFR+组（26.8%+/- 24.9，p = 0.002）和WT组（25.7%+/- 24.6，p = 0.003）。实性模式，分叶状边缘、细毛刺边缘、胸膜回缩发生率较低，ALK重排肿瘤的主要特征是CT影像上的气泡样透亮，建议对肺腺癌患者进行EGFR/ALK靶向TKI治疗，EGFR/ALK检测受组织样本有限和费用压力的限制，pGGO和TDR较低是ALK+的主要临床放射学特征。aEuro cent pGGO和TDR是选择患者进行ALK/EGFR测试的预测因素。
To compare the clinicoradiologic features of tumours with echinoderm anaplastic lymphoma kinase (ALK) rearrangements, epidermal growth factor receptor (EGFR) mutations, or wild type (WT) for both genes in a cohort of patients with lung adenocarcinoma to identify useful characteristics of different gene statuses.In 346 lung adenocarcinoma patients, ALK rearrangements were confirmed with fluorescence in situ hybridisation, and EGFR mutations were determined by pyrosequencing assay. Patients were divided into three groups: ALK rearrangement (ALK+ group, n = 48), EGFR mutation (EGFR+ group, n = 166), and WT for both genes (WT group, n = 132). Chest computed tomography (CT) examinations were performed in all patients. The percentages of ground-glass opacity volume (pGGO) and tumour shadow disappearance rate (TDR) were measured using semi-automated nodule assessment software.The pGGO was significantly lower in the ALK+ group (25.1 % +/- 24.3) than in the EGFR+ group (37.2 % +/- 25.7, p < 0.001) and the WT group (36.1 % +/- 24.6, p = 0.001). The TDR in the ALK+ group (17.3 % +/- 25.1) was significantly lower than in the EGFR+ group (26.8 % +/- 24.9, p = 0.002) and the WT group (25.7 % +/- 24.6, p = 0.003).Solid pattern with lower incidence of lobulated border, finely spiculated margins, pleural retraction, and bubble-like lucency on CT imaging are the main characteristics of ALK rearrangement tumours.aEuro cent EGFR/ALK testing is recommended for lung adenocarcinoma patients for EGFR/ALK-targeted TKI therapy.aEuro cent EGFR /ALK testing is restricted by limited tissue samples and cost pressures.aEuro cent Lower pGGO and TDR are the main clinicoradiological characteristics of ALK+ tumours.aEuro cent pGGO and TDR are predictive factors for selecting patients for ALK/EGFR testing.