The Relationship Between The CT Characteristics Of Peripheral Pulmonary Adenocarcinoma And The Epidermal Growth Factor Receptor Mutation Status

Purpose: To retrospectively identify relationship between epidermal growth factor receptor(EGFR)mutation status,clinic characteristics and computed tomographic characteristics in surgically lung adenocarcinomas in a cohort of Chinese patients.Materials and methods: preoperative chest CT findings and clinic characteristics were retrospectively evaluated in 255 surgically resected lung adenocarcinomas.A total 11 CT descriptors were assessed(tumor size,air-bronchogram,lobulation,speculation,tumor cavitation,pleural retraction,peripheral fibrosis,peripheral emphysema,vascular convergence,texture,calcification).A total 7 clinic characteristics were assessed(median age,sex,smoking history,histologic subtype,stage,location,EGFR mutation status),Among them,40 patients were excluded due to the following exclusion criteria:1.centraltype carcinoma of lung or pulmonary atelectasis;2.patients did not undergo surgery;3.patients received preoperative treatment,such as radiation therapy or chemotherapy 4.interval between CT and subsequent surgery exceeded 1 month,finally,215 patients were included.To meet the inclusion criteria and exclusion criteria,215 patients,according to the EGFR mutation status,were divided into EGFR mutation group and wild group,then according to the categories of EGFR mutation were divided into EGFR-19 deletion group,L858 R group and wild group.EGFR mutation at exons 18-21 were determined by using the Amplification Refractory Mutation System(ARMS).For continuous variable,intraclass correlation of coefficient was calculated.The Wilcox on rank sum test and the x 2 test were used to compare medians and proportions between two groups,respectively.multiple logistic regression analyses were performed to identify independent factors of harboring EGFR mutation status.Results: EGFR mutations were found in 137(63.72%)of 215 patients.mutation werefound more frequently in a female patients(P=0.001).those who occurred in both lower lobes(P=0.046);pleural retraction(P=0.07);mix or solid ground-glass opacity(P<0.001).the most important and signicantly independent prognostic factors of harboring EGFR-activating mutation for the model with both clinical variables and CT features were those who occurred in both lower lobes(both lower lobes:p=0.009,OR=2.495,95%CI=1.262-4.935);those with mix or soild ground-glass opacity(MGGN:p<0.001,OR=33.454,95%CI=6.584-169.984;SGGN:p<0.001,OR=52.026,95%CI= 6.604-409.879)Conclusion: CT imaging features of lung adenocarcinomas in combination with clinical variables can be used to prognosticate EGFR mutation status.