CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas
Abstract 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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | Cancer Imaging |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40644-020-00330-1 |
| _version_ | 1818858740329218048 |
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| author | Xiaoyu Han Jun Fan Jin Gu Yumin Li Ming Yang Tong Liu Nan Li Wenjuan Zeng Heshui Shi |
| author_facet | Xiaoyu Han Jun Fan Jin Gu Yumin Li Ming Yang Tong Liu Nan Li Wenjuan Zeng Heshui Shi |
| author_sort | Xiaoyu Han |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-19T09:01:05Z |
| format | Article |
| id | doaj.art-687af09670234611a70f7282054ffd76 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-12-19T09:01:05Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-687af09670234611a70f7282054ffd762022-12-21T20:28:28ZengBMCCancer Imaging1470-73302020-07-0120111310.1186/s40644-020-00330-1CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomasXiaoyu Han0Jun Fan1Jin Gu2Yumin Li3Ming Yang4Tong Liu5Nan Li6Wenjuan Zeng7Heshui Shi8Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract 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.http://link.springer.com/article/10.1186/s40644-020-00330-1AdenocarcinomaEpidermal growth factor receptorAnaplastic lymphoma kinaseX-ray computed tomography |
| spellingShingle | Xiaoyu Han Jun Fan Jin Gu Yumin Li Ming Yang Tong Liu Nan Li Wenjuan Zeng Heshui Shi CT features associated with EGFR mutations and ALK positivity in patients with multiple primary lung adenocarcinomas Cancer Imaging Adenocarcinoma Epidermal growth factor receptor Anaplastic lymphoma kinase X-ray computed tomography |
| 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 | Adenocarcinoma Epidermal growth factor receptor Anaplastic lymphoma kinase X-ray computed tomography |
| url | http://link.springer.com/article/10.1186/s40644-020-00330-1 |
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