| Objective: By analyzing the correlation between EGFR mutation status and lung CT imaging characteristics and clinical characteristics in lung adenocarcinoma patients in Hainan region,to provide strong imaging genomic evidence for clinically predicting gene mutation and reasonably selecting targeted therapeutic drugs for lung adenocarcinoma patients.Methods:Retrospective collection of clinical data and pulmonary CT data on194 patients with lung adenocarcinoma tested by the EGFR gene from January2016 to September 2019 were collected at the First Affiliated Hospital of Hainan Medical College,and all patients were not treated with cancer.It was divided into 89 cases in EGFR mutation group and 105 cases in the wild group,after univariate analysis and multivariate regression analysis,analyze the risk predictors associated with EGFR gene mutation and mutation subtype,at last,the diagnostic efficacy of CT imaging features was analyzed by ROC curve.Results:1.Of the 194 patients with primary lung adenocarcinoma who completed e GFR gene testing in this study,there were 89 cases of mutation-positive patients with a total mutation rate of 45.88 percent,of which 48 cases of Exon19 delmutation with mutation rate of 53.93%;Exon21 L858 R mutation 35 cases with mutation rate of 39.33%,rare mutation(including Exon21 L858 Q site mutation 2 cases,Exon-20 insertion mutation3 cases,Exon-18 1 case of G719 X mutation)rate was 6.74%.The EGFR gene mutation occurs mainly on the 19 th and 21 st exons.2.This study found that in 7 clinical characteristics such as sex,age,smoking history,drinking history,family history,hypertension history,diabetes history,women,nonsmokers,non-drinkers have higher EGFR mutation rates,and have statistical significance(P<0.05),for age,whether or not to have high pressure and diabetes,tumor family history,mutation group and wild group differences were not statistically significant(P>0.05).A stratified analysis of gender and smoking status showed that non-smokers in male patients were more likely to have EGFR mutations than smokers(P<0.05).EGFR mutations were shown in a combined multifactored regression analysis of clinical and CT signs.A reliable prediction indicator of gene mutation.Further research and analysis of exon-19 and Exon-21 two mutant subtypes,the results showed that there was no significant correlation between the above seven clinical characteristics and the two mutant subtypes(P<0.05).3.this study analyzed 19 lung CT imaging features,showed that vascular clustering,segment-level and above airway obstruction,intrapulmonary metastasis,vertical or pulmonary lymph node metastasis were associated with EGFR gene mutations(P<0.05).In the multi-factor regression analysis,it suggested that tumors have leaf protrusion,vascular cluster ingestion,intrapulmonary metastasis,no lung gate,or vertical lymph node metastasis can predict EGFR gene mutations.The ROC curve about on CT imaging characteristics showed an area of 0.735 under the curve and when the boundary value was taken at 0.511,the sensitivity of the EGFR gene mutation was 64.0% and the specificity was 71.4%,In the comparative analysis of the two mutant subgroups,showed that the 19 imaging features had no statistical difference between Exon-19 and Exon-21 subgroups(P>0.05).Conclusions: In patients with primary lung adenocarcinoma in Hainan,there was a correlation between female,no smoking history and no drinking history and EGFR gene mutation,but its predictive value of EGFR mutation was low.The characteristics of CT imaging include leaf protrusion,vascular cluster ingresss,intrapulmonary metastasis,no Pulmonary door or vertical lymph node metastasis are independent risk factors for Mutation of EGFR;ROC curve suggests that the CT feature has a higher diagnostic efficiency on EGFR mutation,and the area under the curve is 0.735,which can better distinguish the mutation state of the EGFR gene. |
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