The Study In Correlation Between Epidermal Growth Factor Receptor Mutations With CT Imaging Characteristics And Clinical Features In Lung Adenocarcinoma Patients

OBJECTIVES:1.To explore the correlation between EGFR mutations in lung adenocarcinoma with chest CT features and clinical features;2.To explore the correlation between EGFR 19 exon and EGFR 21 exon mutations in lung adenocarcinoma with chest CT features and clinical features.METHODS:1.Information of patients with lung adenocarcinoma who were admitted to our hospital from June 2015 to December 2018 were collected:(1)medical history(age,gender,smoking history);(2)tumor markers : CEA,NSE,CY211;(3)intrapulmonary and distant metastasis(bone,brain,liver,adrenal);(4)Chest CT signs(primary tumor location,tumor size,tumor CT density,lobulation,cavity,burr,pleural effusion);(5)EGFR mutation status.2.Datas were analyzed by single factor analysis and multifactor analysis Using SPSS 22.0 software.RESULUTS:1.Total of 225 lung adenocarcinoma patients,125 with EGFR mutation,the mutation rate were 55.56%.There were 55 patients with EGFR 19 exon mutations and 60 patients with EGFR 21 exon mutations,accounting for 92%of the total mutations.2.Female patients EGFR mutation rate were 68.0%;male patients mutation rate were 46.1%(P = 0.001);smoking patients EGFR mutation rate were 44.4%;non-smoking history patients EGFR mutation rate were 63.0%(P=0.006);CEA elevated patients EGFR mutation rate were 67.2%;CEA normal group patients EGFR mutation rate were 38.5%(P = 0.001).The CT density of tumor lesions in the EGFR mutant group were(43.68±13.90)HU,CT density of tumor lesions in the wild type group was(39.20±11.36)HU(P = 0.011);the mutation rate of EGFR in tumor lesions with burr group were 67.6%.;the EGFR mutation rate intumor free burr group were 43.9%(P = 0.001).3,Patients with EGFR 19 mutation group compared with wild type group,the difference of gender(P =0.004),age(P =0.035),CEA value(P = 0.001),bone metastasis(P = 0.05),CT density values(P =0.035)and burrs(P = 0.002)were statistically significant.4.Patients with EGFR 21 mutation group compared with wild type group,the difference of gender(P value0.009),history of smoking(P = 0.002),CEA value(P =0.018),CT density value(P=0.041)and between burrs(P =0.019)was statistically significant.5.Patients with EGFR 19 mutation patients compared with EGFR 21 mutation patients,the difference of bone metastasis(P =0.04)was statistically significant.CONCLUSIONS: 1.The EGFR mutation rate were 55.56%,the 19 exon mutation accounted for 44% of the total number of mutations,and the 21 exon mutation accounted for 48% of the total number of mutations.2,Female,no smoking history,elevated CEA,tumor lesions with burr group patients EGFR mutation rate were higher than male,smoking history,CEA normal,tumor lesions without burr group;EGFR mutation group patients CT density higher than wild Type group.Female,elevated CEA,and burrs are Predictive factors for EGFR mutations.3,Female,CEA elevation,bone metastasis,tumor lesions with burr group patients EGFR 19 exon mutation rate were higher than male,CEA normal,no bone metastasis,no burr group;EGFR 19 exon mutation group patients younger than the wild type group,The CT density was higher than that of the wild type group.Female,elevated CEA,and burr were Predictive factors for exon EGFR 19 mutations.4,Female,no smoking history,elevated CEA,tumor lesions with burr group patients EGFR 21 exon mutation rate were higher than male,smoking history,CEA normal,no burr group.The CT density of the EGFR 21 exon mutation group were higher than that of the wild type group.Elevated CEA and burr are Predictive factors for EGFR 21 exon mutation.5.The incidence of bone metastasis in the EGFR 19 exon mutation group patients was higher than EGFR 21 exon mutation group.