The exon 19 and 21 in Epidermal Growth Factor Receptor (EGFR) mutation are the most common subtype of lung adenocarcinoma, and the strongest predictive biomarker for progression-free survival and tumor response. Although some studies have shown differences in radiological features between cases with and without EFGR mutations, they lacked necessary stratification. This article is to evaluate the association of CT features between the wild type and the subtype (exon 19 and 21) of EGFR mutations in patients with lung adenocarcinoma. Of the 721 finally included patients, 132 were positive for EGFR mutation in exon 19, 140 were positive for EGFR mutation in exon 21, and 449 were EGFR wild type. EGFR mutation in exon 19 was associated with a small-maximum diameter (28.51 ± 14.07) (p < 0.0001); sex (p < 0.0001); pleural retraction (p = 0.0034); and the absence of fibrosis (p < 0.0001), while spiculated margins (p = 0.0095), subsolid density (p < 0.0001) and no smoking (p < 0.0001) were associated with EGFR mutation in exon 21. Receiver Operating Characteristic (ROC) curves suggested that the maximum Area Under the Curve (AUC) was related to the female gender (AUC = 0.636) and the absence of smoking (AUC = 0.681). This study demonstrated the radiological and clinical features could be used to prognosticate EGFR mutation subtypes in exon 19 and 21.

Backgroud:The biopsy samples might be the only tumor material available for testing the EGFR mutation status in some cases, but these samples are often composed of variable ratios of tumor to normal cells. In this study, we sought to build a scoring system to predict Epidermal growth factor receptor (EGFR) exon 19 mutation in lung adenocarcinoma by clinical and radiological features.Methods:Enrolled in this study were 601 patients with lung adenocarcinoma. Qualitative evaluation of the clinical and radiological features included 25 aspects. Statistical analysis was used to assess the association of these features between the EGFR wild type and exon 19 mutation, based on a clinical scoring system built by the statistical model and the experience of the radiologists.Results:EGRF-exon-19-mutation was associated with the female gender [odds ratios (OR), 2.573; 95% confidence intervals (CI), 1.689–3.920], tumor maximum diameter (OR, 0.357; 95% CI, 0.235–0.542), the absence of emphysema (OR, 0.202; 95% CI, 0.110–0.368), the absence of fibrosis (OR, 0.168; 95% CI, 0.083–0.339), and pleural retraction (OR, 2.170; 95% CI, 1.434–3.285). The clinical scoring model assigned 3 points to the female gender, 2 points to small tumor maximum diameter (≤34.5 mm), 2 to the absence of emphysema, 2 to the absence of fibrosis, and 1 to the presence of pleural retraction.Conclusions:The scoring system based on the statistical analysis of clinical and radiological features may be a new alternative to the prediction of EGFR mutation subtypes.

Background: Cryoablation is an interdisciplinary, widely used treatment approach for several types of solid tumors, making it difficult to obtain a comprehensive picture of its current status and popular research topics. This study aimed to use a bibliometric approach to understand important research themes and trends in cryoablation and oncology. Methods: Literature studies on cryoablation and oncology from 2001 to 2020 were extracted from the Web of Science. A bibliometric analysis was performed based on the annual publication volume, several journal articles and local citation score, and distribution of keywords and trends in the literature using tools such as COOC version 9.94, VOSviewer version 1.6.17, and the bibliometrix version 3.1.3 R package. Results: This study included 2793 publications. Total yearly publications have plateaued over the last 20 years. Five research themes were presented in the keyword network, including clinical applications of cryoablation in liver, lung, kidney, prostate, and skin cancers and comparison of cryoablation with other energy ablations. After 2012, 2 new research topics emerged: synergy between cryoablation and immunotherapy in tumors and cryoablation of Barrett esophagus. The high cited literatures are dominated by studies related to cryoablation for renal and prostate cancer treatment, but they also reflect the recent increasing interest in immunotherapy and bone metastases. Twenty important journals were identified, with Cryobiology publishing the most articles. Conclusion: Bibliometric analysis of studies related to tumor cryoablation can help researchers rapidly comprehend popular topics and determine future trends, guiding future research directions.