Correlation Study Of EGFR And ALK Expression In Lung Adenocarcinoma Based On Spectral CT Parameters

Objective:Energy spectrum CT quantitative parameters and basic imaging signs and epidermal growth factor receptor in lung adenocarcinoma(EGFR)gene,animal micro-associated protein 4-anaplastic lymphoma kinase(EML4-ALK)state the relationship between the fusion gene mutation.Methods: We collected 145 patients with lung adenocarcinoma confirmed by surgery and pathology from the Second Hospital of Lanzhou University from March 2017 to March 2018(including 85 patients with EGFR mutations and 60 patients with EML4-ALK fusion mutations).Two chest CT scans were performed in the chest;among them,42 patients underwent two-stage enhanced CT scan in the GSI scan mode(including 33 patients with EGFR mutations and 9 patients with EML4-ALK fusion mutations).In this study,the patient's clinical data(including gender,age,etc.)and oncogene mutation status were compared.When observing and analyzing the radiographic signs on CT images,two assistant chief physicians of chest imaging assessed the imaging signs on the premise of unknown pathological results;on the workstation of the spectrum scanning of 42 patients with GSI mode scanning Two physicians measured the region of interest,and recorded the energy spectrum quantitative parameters(including iodine concentration,water concentration,single energy CT value from 40 keV to 140keV),and calculated the slope of the energy spectrum curve.In all cases,pathologists used amplification refractory mutation system(ARMS)to detect EGFR and / or EML4-ALK mutations.Results: 1.Significant differences between female patients and EGFR gene mutations in lung adenocarcinoma(P<0.05).There was no significant difference between males,different age groups and EGFR gene mutations in lung adenocarcinoma(P>0.05).There was no significant difference between gender,different age group and EML4-ALK fusion gene mutation in lung adenocarcinoma(P>0.05).2.Significant differences were found between the signs of bronchial aeration sign,vacuoles sign,ground glass-like density,and burr sign in the basic imaging features of 85 patients with EGFR gene mutations in lung adenocarcinoma(P<0.05),however,there was no significant difference between the lesion surrounding emphysema,the collection of blood vessels,the enhancement of homogeneity,and the mutations of the EGFR gene(P>0.05);Vacuoles sign,obstructive pneumonia/pulmonary atelectasis in 60 patients were significantly different from those in lung adenocarcinomas with EML4-ALK fusion gene mutations(P<0.05),and pleural depression sign,bronchial air sign,ground-glass opacity,burr sign,uniform enhancement and lesion location were not significantly different from those in lung adenocarcinoma with EML4-ALK fusion gene mutation(P>0.05).3.Arterial and venous phase of iodine concentration and spectral curve slope,and the single energy under the 40keV~70keV between CT value and EGFR mutations have significant difference in lung adenocarcinomas(P<0.05),the arterial and venous phase concentration of water,the single energy under the 80keV~140keV between CT value and EGFR mutation has no obvious difference(P>0.05).There was no significant difference in iodine concentration,water concentration,energy spectrum curve slope,and single energy CT value between 40 keV ~ 140 keV in the arterial phase and venous phase and in the lung adenocarcinoma EML4-ALK fusion gene mutation(P>0.05).Conclusions: 1.There was a correlation between sex and EGFR gene mutation in lung adenocarcinoma.2.Bronchoalveolar sign,vacuolated sign,glassy density shadow and Mao Cizheng gene mutation can be predicted by Mao Cizheng in the basic imaging signs of lung adenocarcinoma.Vacuolated syndrome,obstructive pneumonia / atelectasis can predict the mutation state of EML4-ALK fusion gene;vacuolar signs,obstructive pneumonia,and atelectasis could predict EML4-ALK fusion gene mutations.3.Energy spectrum CT quantitative parameters of the arterial and venous phase of iodine concentration and spectral curve slope,and the single energy under the 40 keV ~ 70 keV CT values can predict state of EGFR gene mutation;There was no correlation between arterial and venous iodine concentration,water concentration,the slope of the energy spectrum curve,and the single energy CT value under 40keV~140keV,which was not associated with the mutation of EML4-ALK fusion gene.