Radiological and Clinical Features associated with Epidermal Growth Factor Receptor Mutation Status of Exon 19 and 21 in Lung Adenocarcinoma.
Radiological and Clinical Features associated with Epidermal Growth Factor Receptor Mutation Status of Exon 19 and 21 in Lung Adenocarcinoma.
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肺腺癌中与外显子 19 和 21 表皮生长因子受体突变状态相关的放射学和临床特征
DOI：
10.1038/s41598-017-00511-2
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发表时间：
2017-03-23
影响因子：
4.6
通讯作者：
Jiang T
中科院分区：
文献类型：
--
作者：
Shi Z;Zheng X;Shi R;Song C;Yang R;Zhang Q;Wang X;Lu J;Yu Y;Liu Q;Jiang T
表皮生长因子受体（EGFR）突变中的外显子19和21是肺腺癌最常见的亚型，也是无进展生存期和肿瘤缓解的最强预测生物标志物。虽然一些研究显示有和无EFGR突变的病例在放射学特征上存在差异，但缺乏必要的分层。本文旨在探讨肺腺癌患者EGFR突变野生型与EGFR突变亚型（外显子19和21）的CT表现之间的相关性。最终纳入的721例患者中，132例EGFR 19号外显子突变阳性，140例EGFR 21号外显子突变阳性，449例为EGFR野生型。EGFR 19号外显子突变与小-最大直径相关（28.51 ± 14.07）（p < 0.0001）;性别（p < 0.0001）;胸膜回缩（p = 0.0034）;没有纤维化（p < 0.0001），而毛刺边缘（p = 0.0095）、实性下密度（p < 0.0001）和不吸烟（p < 0.0001）与EGFR 21号外显子突变相关。受试者工作特征（ROC）曲线表明，最大曲线下面积（AUC）与女性（AUC = 0.636）和不吸烟（AUC = 0.681）有关。本研究表明，影像学和临床特征可用于预测EGFR外显子19和21突变亚型。
The exon 19 and 21 in Epidermal Growth Factor Receptor (EGFR) mutation are the most common subtype of lung adenocarcinoma, and the strongest predictive biomarker for progression-free survival and tumor response. Although some studies have shown differences in radiological features between cases with and without EFGR mutations, they lacked necessary stratification. This article is to evaluate the association of CT features between the wild type and the subtype (exon 19 and 21) of EGFR mutations in patients with lung adenocarcinoma. Of the 721 finally included patients, 132 were positive for EGFR mutation in exon 19, 140 were positive for EGFR mutation in exon 21, and 449 were EGFR wild type. EGFR mutation in exon 19 was associated with a small-maximum diameter (28.51 ± 14.07) (p < 0.0001); sex (p < 0.0001); pleural retraction (p = 0.0034); and the absence of fibrosis (p < 0.0001), while spiculated margins (p = 0.0095), subsolid density (p < 0.0001) and no smoking (p < 0.0001) were associated with EGFR mutation in exon 21. Receiver Operating Characteristic (ROC) curves suggested that the maximum Area Under the Curve (AUC) was related to the female gender (AUC = 0.636) and the absence of smoking (AUC = 0.681). This study demonstrated the radiological and clinical features could be used to prognosticate EGFR mutation subtypes in exon 19 and 21.