Correlation Between Epidermal Growth Factor Receptor Gene Mutation And Computed Tomography And Clinical Features In Patients With Pulmonary Adenocarcinoma

Part 1: Clinical manifestation of lung adenocarcinomas with epidermal growth factor receptor gene mutationObjective: To study the clinical features of primary pulmonary adenocarcinomas with epidermal growth factor receptor(EGFR)mutation,then to analyze the correlation between EGFR mutation and clinical features.Methods: A total of 192 primary pulmonary adenocarcinoma patients who underwent a complete surgical resection at The No.4 Hospital of Hebei Medical University,between January 2015 and June 2015 comprise the current study population.The mutation analysis of EGFR exon18,19,20 and 21has been carried out in those patients,and the clinical data were available.There were 82 men and 110 women ranging in age from 32 to 83 years(mean,59.23±9.80 years),in which,108 with symptom while 84 without symptom.There were 56 smokers and 136 non-smokers,as well as 46 drinker and 146 nondrinkers.There were also 26 patients with family heredity,while others not.Then analyze the correlation between EGFR mutation and clinical features.Results: The total mutation rate of EGFR was 59.8% in 192 lung adenocarcinoma patients.The mutation rate was 73.6%in female and 41.4% in male,with statistical difference(P<0.001).The mutation rate was 69.1% in patients without symptom while 52.7% in patient with symptom,the difference is statistical significant(P=0.022).The mutation rate in non-smokers and smokers was70.5%and 33.9% respectively,with statistical difference(P<0.001).In drinker the mutation rate was 43.4%,and in nondrinker was 65.1%,with statistical difference(P=0.009)Conclusion: EGFR mutation is more prevalent in patients without symptom,female,non-smokers and nondrinkers.Part 2: Correlation between epidermal growth factor receptorgene mutation and CTObjective: To study the radiological characteristics of primary pulmonary adenocarcinomas with epidermal growth factor receptor(EGFR)mutation,then to analyze the correlation between EGFR mutation and radiological characteristics.To evaluate the diagnostic value of CT characteristics inpredicting the presence of epidermal growth factor receptor(EGFR)gene mutations in lung adenocarcinomas.Methods: A total of 192 primary pulmonary adenocarcinoma patients who underwent a complete surgical resection at The No.4 Hospital of Hebei Medical University,between January 2015 and June 2015 comprise the current study population,Mutation analysis of EGFR exon18,19,20 and 21has been carried out in those patients,and the CT scans were available.Two thoracic radiologists interpreted the CT images.All differences were resolved by discussion until a consensus was reached.CT scans were evaluated for the presence of ground grass opacity(GGO),vacuoles or cavitation,marginal spiculation,marginal lobulation and pleural indentation.GGO proportions and the maximum diameter of the tumor were measured.Results: The maximum tumor diameter was ≤30 mm in 115 of the 192 patients.Of those,77(66.9%)harbored the EGFR mutation,whereas the mutation was found in 10(49.3%)of the 77 patients,the difference is statistical significant(P = 0.015).The mutation rate in pleural indentation was higher than that in tumors excepting it,with statistical difference(P=0.002).The mutation rate was 73.5% in tumors with GGO while 56.9% in tumors without it,it was not statistically significant.EGFR mutation rate is unrelated with speculation,lobulation and vacuoles or cavitation sign.The mutation rate of exon19 was 41.1% in tumors with GGO while 20.8% in tumors without it,the difference is statistical significant(P = 0.013).The mutation rate of exon 21 was 41.2% in tumors with GGO while 31.6% in tumors without it,it was not statistically significant.Conclusion: EGFR mutation is more prevalent in tumors with pleural indentation,GGO and maximum diameter ≤30 mm.The mutation rate of exon19 was higher in tumors with GGO than which without it.The difference is statistical significant.