肺炎型肺癌中EGFR基因突变的影像学及临床特点
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摘要
目的:探讨肺炎型肺癌(P-LC)与EGFR基因突变的关系,分析P-LC不同CT征象与EGFR基因突变的相关性,为临床诊治提供影像学评估。方法:收集经过EGFR基因检测具有完整临床及影像学资料的187例肺腺癌患者,其中37例P-LC,EGFR有效突变组9例,非有效突变组28例。采用多元分析,系统评价临床资料及病变的CT影像特点,并分析其与EGFR基因突变的相关性。结果:P-LC中EGFR突变组与对照组相比,性别、吸烟指数无显著差异(P> 0.1)。P-LC表现为轻度或中等程度强化;其常见CT征象为血管造影征(62%)、枯枝征(57%)。P-LC的EGFR有效突变组与对照组相比,易出现非肿瘤叶结节(P <0.05),OR值19.239(1.306—283.439)。结论:P-LC中EGFR有效突变与性别、吸烟情况关系不大。P-LC具有一定的CT影像学特点,P-LC中EGFR有效突变组与对照组相比,易出现非肿瘤叶肺结节。
Objective To investigate the relationship between pneumonic-type lung carcinoma(P-LC) and EGFR gene mutation, and further analyze the correlation between different CT signs of P-LC and EGFR gene mutation, so as to provide imaging evaluation for clinical diagnosis and treatment. Methods Totally 187 cases of lung adenocarcinoma with complete clinical and imaging data were collected. There were 37 P-LC patients, 9 in effective mutation group and 28 in non-effective mutation group. Multivariate analysis was used to evaluate the clinical data, radiogenomic characteristics and CT imaging features of the lesions. Results There was no significant difference in gender and smoking index between EGFR mutation group and control group in P-LC(P >0.1). P-LC showed mild or moderate enhancement. The common CT signs were angiography(62%) and withered branches(57%). In all 37 cases of P-LC, the patients in EGFR effective mutation group were more likely to have non-tumor nodules than those in the ineffective mutation group, P<0.05, with OR value of 19.239,(1.306—283.439) Conclusion The effective mutation of EGFR in P-LC is not related to gender and smoking. P-LC has certain CT imaging characteristics. Compared with the control group, the patients in EGFR effective mutation group in P-LC is prone to produce non-tumor lobar pulmonary nodules.
Objective To investigate the relationship between pneumonic-type lung carcinoma(P-LC) and EGFR gene mutation, and further analyze the correlation between different CT signs of P-LC and EGFR gene mutation, so as to provide imaging evaluation for clinical diagnosis and treatment. Methods Totally 187 cases of lung adenocarcinoma with complete clinical and imaging data were collected. There were 37 P-LC patients, 9 in effective mutation group and 28 in non-effective mutation group. Multivariate analysis was used to evaluate the clinical data, radiogenomic characteristics and CT imaging features of the lesions. Results There was no significant difference in gender and smoking index between EGFR mutation group and control group in P-LC(P >0.1). P-LC showed mild or moderate enhancement. The common CT signs were angiography(62%) and withered branches(57%). In all 37 cases of P-LC, the patients in EGFR effective mutation group were more likely to have non-tumor nodules than those in the ineffective mutation group, P<0.05, with OR value of 19.239,(1.306—283.439) Conclusion The effective mutation of EGFR in P-LC is not related to gender and smoking. P-LC has certain CT imaging characteristics. Compared with the control group, the patients in EGFR effective mutation group in P-LC is prone to produce non-tumor lobar pulmonary nodules.
引文
[1]Wislez M,Massiani MA,Milleron B,et al.Clinical characteristics of pneumonic-type adenocarcinoma of the lung[J].Chest,2003,123(6):1868-1877.
[2]Garfield DH,Cadranel JL,Wislez M,et al.The bronchioloalveolar carcinoma and peripheral adenocarcinoma spectrum of diseases[J].J Thorac Oncol,2006,1(4):344-359.
[3]Jung JI,Kim H,Park SH,et al.CT differentiation of pneumonictype bronchioloalveolar cell carcinoma and infectious pneumonia[J].Br J radiol,2001,74(882):490-494.
[4]Liu Y,Kim J,Qu F,et al.CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma[J].Radiology,2016,280(1):271-280.
[5]Rizzo S,Petrella F,Buscarino V,et al.CT Radiogenomic Characterization of EGFR,K-RAS,and ALK Mutations in NonSmall Cell Lung Cancer[J].Eur Radiol,2016,26(1):32-42.
[6]Watanabe H,Saito H,Yokose T,et al.Relation between thinsection computed tomography and clinical findings of mucinous adenocarcinoma[J].Ann Thorac Surg,2015,99(3):975-81.
[7]Liu J,Shen JF,Yang CL,et al.High incidence of EGFR Mutations in Pneumonic-type Non-small cell lung Cancer[J].Medicine,2015,94(8):e540.
[8]Kim TJ,Lee CT,Jheon SH,et al.Radiologic Characteristics of Surgically Resected Non-small Cell Lung Cancer with ALKRearrangement or EGFR Mutations[J].Ann Thorac Surg,2016,101(2):473-480.
[9]Antonicelli A,Cafarotti S,Indini A,et al.EGFR-targeted therapy for non-small cell lung cancer:focus on EGFR oncogenic mutation[J].Int J Med Sci,2013,10(3):320-330.
[10]Yoshino I,Nakanishi R,Kodate M,et al.Pleural retraction and intra-tumoral air-bronchogram as prognostic factors for stage Ipulmonary adenocarcinoma following complete resection[J].Int Surg,2000,85(2):105-112.
[11]Luo BJ,Lv PX,Zhou XH,et al.CT image features of 46 cases with pneumonic-type lung cancers[J].Zhonghua Zhong Liu Za Zhi,2007,29(11):860-863.
[12]Hsu JS,Huang MS,Chen CY,et al.Correlation between EGFR mutation status and computed tomography features in patients with advanced pulmonary adenocarcinoma[J].J Thorac Imaging,2014,29(6):357-363.
[13]Hasegawa M,Sakai F,Ishikawa R,et al.CT Features of Epidermal Growth Factor Receptor-Mutated Adenocarcinoma of the Lung:Comparison with Nonmutated Adenocarcinoma[J].JThorac Oncol,2016,11(6):819-826.
[14]Hong SJ,Kim TJ,Choi YW,et al.Radiogenomic correlation in lung adenocarcinoma with epidermal growth factor receptor mutations:Imaging features and histological subtypes[J].Eur Radiol,2016,26(10):3660-3668.
[15]Lee HJ,Kim YT,Kang CH,et al.Epidermal growth factor receptor mutation in lung adenocarcinomas:relationship with CTcharacteristics and histologic subtypes[J].Radiology,2013,268(1):254-264.
[2]Garfield DH,Cadranel JL,Wislez M,et al.The bronchioloalveolar carcinoma and peripheral adenocarcinoma spectrum of diseases[J].J Thorac Oncol,2006,1(4):344-359.
[3]Jung JI,Kim H,Park SH,et al.CT differentiation of pneumonictype bronchioloalveolar cell carcinoma and infectious pneumonia[J].Br J radiol,2001,74(882):490-494.
[4]Liu Y,Kim J,Qu F,et al.CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma[J].Radiology,2016,280(1):271-280.
[5]Rizzo S,Petrella F,Buscarino V,et al.CT Radiogenomic Characterization of EGFR,K-RAS,and ALK Mutations in NonSmall Cell Lung Cancer[J].Eur Radiol,2016,26(1):32-42.
[6]Watanabe H,Saito H,Yokose T,et al.Relation between thinsection computed tomography and clinical findings of mucinous adenocarcinoma[J].Ann Thorac Surg,2015,99(3):975-81.
[7]Liu J,Shen JF,Yang CL,et al.High incidence of EGFR Mutations in Pneumonic-type Non-small cell lung Cancer[J].Medicine,2015,94(8):e540.
[8]Kim TJ,Lee CT,Jheon SH,et al.Radiologic Characteristics of Surgically Resected Non-small Cell Lung Cancer with ALKRearrangement or EGFR Mutations[J].Ann Thorac Surg,2016,101(2):473-480.
[9]Antonicelli A,Cafarotti S,Indini A,et al.EGFR-targeted therapy for non-small cell lung cancer:focus on EGFR oncogenic mutation[J].Int J Med Sci,2013,10(3):320-330.
[10]Yoshino I,Nakanishi R,Kodate M,et al.Pleural retraction and intra-tumoral air-bronchogram as prognostic factors for stage Ipulmonary adenocarcinoma following complete resection[J].Int Surg,2000,85(2):105-112.
[11]Luo BJ,Lv PX,Zhou XH,et al.CT image features of 46 cases with pneumonic-type lung cancers[J].Zhonghua Zhong Liu Za Zhi,2007,29(11):860-863.
[12]Hsu JS,Huang MS,Chen CY,et al.Correlation between EGFR mutation status and computed tomography features in patients with advanced pulmonary adenocarcinoma[J].J Thorac Imaging,2014,29(6):357-363.
[13]Hasegawa M,Sakai F,Ishikawa R,et al.CT Features of Epidermal Growth Factor Receptor-Mutated Adenocarcinoma of the Lung:Comparison with Nonmutated Adenocarcinoma[J].JThorac Oncol,2016,11(6):819-826.
[14]Hong SJ,Kim TJ,Choi YW,et al.Radiogenomic correlation in lung adenocarcinoma with epidermal growth factor receptor mutations:Imaging features and histological subtypes[J].Eur Radiol,2016,26(10):3660-3668.
[15]Lee HJ,Kim YT,Kang CH,et al.Epidermal growth factor receptor mutation in lung adenocarcinomas:relationship with CTcharacteristics and histologic subtypes[J].Radiology,2013,268(1):254-264.