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CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas

BACKGROUND: In multiple primary lung adenocarcinomas (MPLAs), the relationship between imaging and gene mutations remains unclear. This retrospective study aimed to identify the correlation of epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) status with CT chara...

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Autores principales: Han, Xiaoyu, Fan, Jun, Gu, Jin, Li, Yumin, Yang, Ming, Liu, Tong, Li, Nan, Zeng, Wenjuan, Shi, Heshui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372851/
https://www.ncbi.nlm.nih.gov/pubmed/32690092
http://dx.doi.org/10.1186/s40644-020-00330-1
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author Han, Xiaoyu
Fan, Jun
Gu, Jin
Li, Yumin
Yang, Ming
Liu, Tong
Li, Nan
Zeng, Wenjuan
Shi, Heshui
author_facet Han, Xiaoyu
Fan, Jun
Gu, Jin
Li, Yumin
Yang, Ming
Liu, Tong
Li, Nan
Zeng, Wenjuan
Shi, Heshui
author_sort Han, Xiaoyu
collection PubMed
description BACKGROUND: In multiple primary lung adenocarcinomas (MPLAs), the relationship between imaging and gene mutations remains unclear. This retrospective study aimed to identify the correlation of epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) status with CT characteristics in MPLA patients. METHODS: Sixty-seven patients (135 lesions) with MPLAs confirmed by pathology were selected from our institution. All subjects were tested for EGFR mutations and ALK status and underwent chest CT prior to any treatment. The criteria for MPLA definitions closely adhered to the comprehensive histologic assessment (CHA). RESULTS: Among MPLA patients, EGFR mutations were more common in females (p = 0.002), in those who had never smoked (p = 0.010), and in those with less lymph node metastasis (p < 0.001), and the tumours typically presented with ground-glass opacity (GGO) (p = 0.003), especially mixed GGO (p < 0.001), and with air bronchograms (p = 0.012). Logistics regression analysis showed that GGO (OR = 6.550, p = 0.010) was correlated with EGFR mutation, while air bronchograms were not correlated with EGFR mutation (OR = 3.527, p = 0.060). A receiver operating characteristic (ROC) curve yielded area under the curve (AUC) values of 0.647 and 0.712 for clinical-only or combined CT features, respectively, for prediction of EGFR mutations, and a significant difference was found between them (p = 0.0344). ALK-positive status was found most frequently in MPLA patients who were younger (p = 0.002) and had never smoked (p = 0.010). ALK positivity was associated with solid nodules or masses in MPLAs (p < 0.004) on CT scans. Logistics regression analysis showed that solid nodules (OR = 6.550, p = 0.010) were an independent factor predicting ALK positivity in MPLAs. For prediction of ALK positivity, the ROC curve yielded AUC values of 0.767 and 0.804 for clinical-only or combined CT features, respectively, but no significant difference was found between them (p = 0.2267). CONCLUSION: Among MPLA patients, nonsmoking women with less lymph node metastasis and patients with lesions presenting GGO or mixed GGO and air bronchograms on CT were more likely to exhibit EGFR mutations. In nonsmoking patients, young patients with solid lesions on CT are recommended to undergo an ALK status test.
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spelling pubmed-73728512020-07-21 CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas Han, Xiaoyu Fan, Jun Gu, Jin Li, Yumin Yang, Ming Liu, Tong Li, Nan Zeng, Wenjuan Shi, Heshui Cancer Imaging Research Article BACKGROUND: In multiple primary lung adenocarcinomas (MPLAs), the relationship between imaging and gene mutations remains unclear. This retrospective study aimed to identify the correlation of epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) status with CT characteristics in MPLA patients. METHODS: Sixty-seven patients (135 lesions) with MPLAs confirmed by pathology were selected from our institution. All subjects were tested for EGFR mutations and ALK status and underwent chest CT prior to any treatment. The criteria for MPLA definitions closely adhered to the comprehensive histologic assessment (CHA). RESULTS: Among MPLA patients, EGFR mutations were more common in females (p = 0.002), in those who had never smoked (p = 0.010), and in those with less lymph node metastasis (p < 0.001), and the tumours typically presented with ground-glass opacity (GGO) (p = 0.003), especially mixed GGO (p < 0.001), and with air bronchograms (p = 0.012). Logistics regression analysis showed that GGO (OR = 6.550, p = 0.010) was correlated with EGFR mutation, while air bronchograms were not correlated with EGFR mutation (OR = 3.527, p = 0.060). A receiver operating characteristic (ROC) curve yielded area under the curve (AUC) values of 0.647 and 0.712 for clinical-only or combined CT features, respectively, for prediction of EGFR mutations, and a significant difference was found between them (p = 0.0344). ALK-positive status was found most frequently in MPLA patients who were younger (p = 0.002) and had never smoked (p = 0.010). ALK positivity was associated with solid nodules or masses in MPLAs (p < 0.004) on CT scans. Logistics regression analysis showed that solid nodules (OR = 6.550, p = 0.010) were an independent factor predicting ALK positivity in MPLAs. For prediction of ALK positivity, the ROC curve yielded AUC values of 0.767 and 0.804 for clinical-only or combined CT features, respectively, but no significant difference was found between them (p = 0.2267). CONCLUSION: Among MPLA patients, nonsmoking women with less lymph node metastasis and patients with lesions presenting GGO or mixed GGO and air bronchograms on CT were more likely to exhibit EGFR mutations. In nonsmoking patients, young patients with solid lesions on CT are recommended to undergo an ALK status test. BioMed Central 2020-07-20 /pmc/articles/PMC7372851/ /pubmed/32690092 http://dx.doi.org/10.1186/s40644-020-00330-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Han, Xiaoyu
Fan, Jun
Gu, Jin
Li, Yumin
Yang, Ming
Liu, Tong
Li, Nan
Zeng, Wenjuan
Shi, Heshui
CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title_full CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title_fullStr CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title_full_unstemmed CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title_short CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
title_sort ct features associated with egfr mutations and alk positivity in patients with multiple primary lung adenocarcinomas
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7372851/
https://www.ncbi.nlm.nih.gov/pubmed/32690092
http://dx.doi.org/10.1186/s40644-020-00330-1
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