Correlations Between Imaging Features Of Non-small Cell Lung Cancer And EGFR Gene Mutation

Part 1: Correlations between CT Enhanced Characteristics of Non-small Cell Lung Cancer and EGFR Gene MutationObjective: On the basis of retrospective method, the present study explores the relationship between CT enhanced features of peripheral non-small cell lung cancer and EGFR gene mutation.Methods: Collected 103 peripheral non-small cell lung cancer cases with complete clinical data who received primary diagnosis from Jan. 1st 2009 to Aprl 30 th 2016, guaranteed that all the explicit histopathological types of cases were available through surgeries(6), punctures(83) or fiber bronchoscopy biopsies(14), furthermore, detected and analyzed EGFR gene mutation of tissue or cell samples in all cases through ARMS or gene sequencing method, evaluated the relationship between imaging enhanced features and EGFR gene mutations by CT signs of each patient. Analyzed statistically the correlation between enhanced sign and gene mutation, and we will take the degree of enhancement as the predictors of EGFR mutations to draw receiver ROC(operating characteristic curve). Taking proved statistical significance as P<0.05.Results: In the reinforced characteristic of lung cancer, the reinforced values and degrees apparently shared relations with EGFR gene mutation(P<0.05). The ROC curve of enhancement degree in different parts of lung cancer show that, in case that the peripheral lung cancer’s critical value is 44.5Hu, its accuracy can reach 69.4%; in case that central lung cancer’s critical value is 31.5Hu, its accuracy can reach 65.9%; in case that mixed types lung cancer’s critical value is 41.5Hu, the accuracy was 68.9%. The area values under the ROC curve of these three types are from the 0.7 to 0.9, and central lung cancer’s negative predictive value is 100%.Conclusion: CT enhancement degree can be an predictor with EGFR mutations; there are different critical value when taking CT enhancement degree as predictive factor of EGFR mutations among peripheral and central lung cancer. In the reinforced CT signs of lung cancer, the higher enhancement degree is the higher probability of EGFR mutations’ incidence.Part 2: Correlations between CT Characteristics of Peripheral Non-small Cell Lung Cancer and EGFR Gene MutationObjective: On the basis of retrospective method, the present study explores relationship between specific CT signs and clinical features of peripheral non-small cell lung cancer and EGFR gene mutation.Methods: Collected 63 peripheral non-small cell lung cancer cases with complete clinical data who received primary diagnosis from Jan. 1st 2009 to April 30 th 2016, guaranteed that all the explicit histopathological types of cases were available through surgeries(4), punctures(54) or fiber bronchoscopy biopsies(5), furthermore, detected and analyzed EGFR gene mutation of tissue or cell samples in all cases through ARMS or gene sequencing method, evaluated the correlation between imaging features and EGFR gene mutations by CT signs of each patient. Specific CT indexes for evaluation included: region; size; relations with bronchus(truncation of bronchus beyond neoplasms, narrowing and interrupted bronchus interior to neoplasms); lobulation; spiculation; vascular convergence sign; pleural effusion; pericardial effusion; pleural indentation; pleural thickness; lymph node metastasis;lung metastasis; bone metastasis; liver metastasis. Analyzed statistically the correlation between each sign and gene mutation. Taking proved statistical significance as P<0.05.Results: 29 of the totally 63 patients(46.03%) suffering non-small cell lung carcinoma presented EGFR gene mutation. There proved no remarkable relevance among sex, smoke history and EGFR gene mutation of lung cancer. In the thoracic CT signs, vascular convergence took up 32.14% in tumors with mutation, while 57.14% in tumors without vascular convergence, which presented statistical significance(P<0.05). The pleural indentation occupied 37.21% in tumors with mutation, while 65.00% in tumors without pleural indentation, which suggested relevance(P<0.05), lung cancer with bone metastasis occupied 66.67% in tumors with mutation, while 37.78% in tumors without bone metastasis, which existed statistical significance(P<0.05). However, lung cancer with other features didn’t witness any correlation with EGFR gene mutation.Conclusion: In the peripheral non-small cell lung cancer, the mutation gained its popularity in lung cancer with bone metastasis,while pleural indentation and vascular convergence appeared common in tumors without mutation.