Correlation Of EGFR Mutation With Histological Subtypes And CT Imaging Features In Lung Adenocarcinoma

Objective: In this study,we investigated the relationship between EGFR mutation and histological subtypes and CT imaging features of lung adenocarcinoma.To determine whether histopathological classification can be used as a bridge to analyze the relationship between EGFR and CT imaging features,and to analyze the Overall Survival(OS)of selected patients.Methods: Specimens of 96 patients with lung adenocarcinoma who underwent surgical resection in the First Affiliated Hospital of Anhui Medical University from January2017 to December 2019 were selected.The samples were tested for mutations in the EGFR gene,and clinical data including age,sex and prognosis were collected.To interpret the histological classification of lung adenocarcinoma patients;CT imaging features were collected,including lobulation,burr sign,bronchial truction sign,vacuole sign,pleural depression sign,tumor size,vascular cluster sign,and presence of Ground Glass Opacity(GGO).Statistics uses the chi-square test.The correlation between EGFR mutation and clinical factors,histopathological types and CT imaging features was analyzed.We also analyzed whether there was any association between the histopathological types associated with EGFR mutation and CT imaging features associated with EGFR mutation.Kaplan-Meier method was used for OS of EGFR mutation group and non-mutation group.Results :(1)The total EGFR mutation rate was 59.4%(57/96 cases).(2)The chi-square test was used for EGFR mutation and general clinical data.The outcome was that 38 of 55 female patients had EGFR mutations and 19 of 47 male patients had EGFR mutations,and the difference between the two groups was statistically significant,P<0.05;The mean age was 62 years in the EGFR mutant group and 61 years in the non-mutant group,P=0.635;(3)Statistical analysis of EGFR mutation and histological classification was performed.The outcome was that EGFR mutation rate was higher in the acinus dominant subtype and mucus dominant subtype than in the other subtypes,The difference was statistically significant,P<0.05;(4)Statistical analysis of EGFR mutation and CT imaging was performed.The outcome was that EGFR mutation rate was higher in the group containing GGO than in the group without GGO,P<0.05,the group containing GGO was divided into ≥50% and<50% according to G/T ratio,the outcome was that EGFR mutation was not associated with G/T ratio,P>0.05,and P<0.05 in other CT feature groups.(5)Statistical analysis was performed on the pathological tissue types(acinus dominant subtypes,mucus dominant subtypes)and CT imaging features(whether there was GGO)related to EGFR mutation respectively,and the outcome was that there was statistically significant difference in whether there was GGO in the group of acinus dominant subtypes(P<0.05)(6)Multivariate Logistic regression analysis indicated that female,acinus dominant subtype and containing GGO had higher predictive value for EGFR mutation.(7)The median OS in the EGFR mutant group was 41 months,and that in the non-mutant group was 23 months,which was significantly longer in the mutant group than in the non-mutant group,P<0.05.Conclusion: The OS in the EGFR mutant group was longer than that in the wild group.EGFR mutation was correlated with the acinus dominant subtype in pathological tissue type and the GGO feature in CT imaging,and the acinus dominant subtype was also correlated with the presence of GGO,indicating that the acinus dominant subtype could be used as a bridge to analyze the correlation between EGFR mutation and the presence of GGO.