Radiological and Clinical Features associated with Epidermal Growth Factor Receptor Mutation Status of Exon 19 and 21 in Lung Adenocarcinoma.
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.
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Zhang
Z
Shi
Clinical Nutrition Department, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xuan
X
Zheng
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Ruifeng
R
Shi
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Changen
C
Song
Department of Radiology, Yanan University affiliated hospital, Shanxi, China.
Runhong
R
Yang
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Qianwen
Q
Zhang
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Xinrui
X
Wang
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Jianping
J
Lu
Department of Pathology, Changhai Hospital, Second Military Medical University, Shanghai, China. dandan2080007@163.com.
Yongwei
Y
Yu
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China. 529809007@qq.com.
Qi
Q
Liu
Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China. laijiangtaotao@163.com.
Tao
T
Jiang
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D066246:ErbB Receptors / Q000235:genetics*; D005091:Exons; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
C512478:EGFR protein, human; D066246:ErbB Receptors