Analysis Of The CT Signs And Clinical Characteristics In EGFR Positive Patients With Non-small Cell Lung Cancer

Objective: Lung cancer is one of the most common malignant tumors in China and worldwide,among which Non-small cell lung cancer(NSCLS)accounts for about 80%~85%.The purpose of this study is mainly to explore the correlation between CT signs,clinical characteristics and epidermal growth factor receptor(EGFR)gene mutation in NSCLC patients,thus providing a convenient and useful index for clinicians to predict EGFR gene mutation and evaluate the curative effect.Methods: The general clinical data of non-small cell lung cancer patients in our hospital from January 2015 to September 2017 were collected.All of these cases were confirmed as non-small cell lung cancer patients after pathological examination.And all patients have undergone thoracic CT examination and serum tumor markers detection before clinical antitumor treatment.The related data including EGFR gene expression,mutation site,clinical features,CT signs,levels of serum tumor markers and so on were collected and retrospectively analyzed to find out whether there was a certain correlation.Results: Of the 189 patients with non-small cell lung cancer,one group is the maximum lesion diameter ≤3cm group,its mutation rate is 59.7%,whereas the mutation rate was found 41.5% in another group(the maximum lesion diameter >3cm),the difference was statistically significant(P<0.05).The rate of EFGR mutation in patients with lymph node metastases(64.2%)was higher than that in the non lymph node metastasis group(47.5%),with statistical difference(P<0.05).EGFR gene mutation rate is unrelated with spiculation,lobulation,cavitation sign/vacuoles sign,vessel convergence sign,pleural indentation,air bronchogram,pleural effusion and ground glass shadow(GGO).In clinical features,the total mutation rate of EGFR gene was 53.4%,and the mutation site was generally located mainly in exon-19 and exon-21.The EFGR mutation rate was 70.6% in female and 43.8% in male.The mutation rate in non-smokers and smokers was 64.1% and 36.1%.The mutation rate of adenocarcinoma(60.9%)was higher than that of non adenocarcinoma(18.2%).The mutation rate was 69.0% in patients without clinical symptoms while 49.0% in patients with symptoms.The mutation rate of CEA>5ng/ml(61.8%)was higher than that of the CEA< 5ng/ml group(43.78%).The mutation rate of highly differentiated NSCLC patients is higher than that of middle and low differentiation.And all their differences were statistically significant(P<0.05).EGFR gene mutation rate is unrelated with age,drinking history,family history,clinical staging,CA199,CA125,NSE.Conclusions: For patients with NSCLC,there are a higher rate of EGFR mutation in CT signs characterized by maximum lesion diameter≤3cm and lymph node metastasis.In clinical features,EGFR mutation rate was higher in women,adenocarcinoma,non smoking,well-differentiated,no clinical symptoms,and high CEA level group.