Contribution of18Fluorodeoxyglucose positron emission tomography uptake and TTF-1 expression in the evaluation of the EGFR mutation in patients with lung adenocarcinoma

Kanmaz, Zehra Dilek; Aras, Gülfidan; Tuncay, Esin; Bahadır, Ayşe; Kocatürk, Celalettin; Yaşar, Zehra; Öz, Büğe; Özkurt, Canan Ünlü; Gündoğan, Cihan; Çermik, Tevfik Fikret

doi:10.3233/cbm-160588

Cited by 17 publications

(16 citation statements)

References 37 publications

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“…As mentioned above, PMA was less likely to harbor EGFR mutations but had a higher frequency rate of KRAS mutations. Consistent with these findings, many studies have reported that TTF‐1 has a strong relationship with EGFR‐mutant lung adenocarcinoma and that TTF‐1 is an oncogene in lung adenocarcinomas with EGFR mutation . Shanzhi et al found that the levels of TTF‐1 expression may guide clinical therapy for LUAD with EGFR mutations .…”

Section: Discussionmentioning

confidence: 71%

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Chen

et al. 2019

Cancer Medicine

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Background: Primary pure mucinous adenocarcinoma of the lung (PMA) is a rare subtype. However, correlations between clinicopathological features and genetic phenotypes with survival have not been described comprehensively. Methods: Pure mucinous adenocarcinoma patient information collected from the Surveillance, Epidemiology, and End Results (SEER) database, the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University (FDZSH), and the Cancer Genome Atlas (TCGA) were extracted, evaluated, and compared with other lung adenocarcinomas (LUAD) patient data. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses were performed to explore the functional importance of underlying molecular changes. Overall survival (OS) was evaluated with the Kaplan-Meier method. Univariate and multivariate analysis through Cox proportional hazard regression identified risk factors that predicted OS, and the results were used to construct a nomogram to predict OS for PMA patients. Results: Overall, 3622 patients, 41 patients, and 15 patients with PMA were identified from the SEER, FDZSH, and TCGA databases, respectively. There were 345 differentially expressed genes, 30 differentially mutated genes and 72 differentially methylated genes were identified between PMA and other LUAD samples. In the SEER database, PMA had a better prognosis compared to other LUAD. Compared with patients with other LUAD, patients with PMA exhibited unique clinicopathological features, including fewer grade III/IV tumors, less pleural invasion, more early-stage cancer, and more lower lobe carcinomas. Multivariate analyses showed that age, race, T stage, N stage, surgery, and chemotherapy were independent risk factors. The nomogram had a calibration index of 0.724. Conclusions: Our research identified unique clinicopathological characteristics and genetic phenotypes for PMA and other LUAD. The nomogram accurately predicted OS. K E Y W O R D S clinicopathological features, genetic analysis, nomogram, pure mucinous adenocarcinoma, the surveillance, epidemiology, and end results 518 | CHEN Et al. How to cite this article: Chen Z, Li M, Ma K, et al. Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma. Cancer Med. 2020;9:517-529. https ://

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Section: Discussionmentioning

confidence: 71%

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Chen

et al. 2019

Cancer Medicine

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“…13 Kanmaz et al made a similar conclusion, with an SUV max cut-off value of 13.65 as the predictor. 12 Our results indicated the 18 F-FDG PET/CT has low sensitivity and specificity in predicting EGFR mutations. Comparison of mean SUV max between EGFR mutant and wild-type was first pooled with WMD to determine the relationship between EGFR status and FDG uptake.…”

Section: Discussionmentioning

confidence: 69%

“…Some studies have confirmed that higher uptake of 18 F-FDG is predictive of mutant EGFR in patients with NSCLC, [8][9][10] while several other studies have shown the opposite result. [11][12][13] A systematic review is needed to clarify this point.…”

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confidence: 99%

Can¹⁸F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis

Wang

Cui

et al. 2021

BMJ Open

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ObjectivesThis study aimed to explore the diagnostic significance of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT for predicting the presence of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC).DesignA systematic review and meta-analysis.Data sourcesThe PubMed, EMBASE and Cochrane library databases were searched from the earliest available date to December 2020.Eligibility criteria for selecting studiesThe review included primary studies that compared the mean maximum of standard uptake value (SUVmax) between wild-type and mutant EGFR, and evaluated the diagnostic value of 18F-FDG PET/CT using SUVmax for prediction of EGFR status in patients with NSCLC.Data extraction and synthesisThe main analysis was to assess the sensitivity and specificity, the positive diagnostic likelihood ratio (DLR+) and DLR−, as well as the diagnostic OR (DOR) of SUVmax in prediction of EGFR mutations. Each data point of the summary receiver operator characteristic (SROC) graph was derived from a separate study. A random effects model was used for statistical analysis of the data, and then diagnostic performance for prediction was further assessed.ResultsAcross 15 studies (3574 patients), the pooled sensitivity for 18F-FDG PET/CT was 0.70 (95% CI 0.60 to 0.79) with a pooled specificity of 0.59 (95% CI 0.52 to 0.66). The overall DLR+ was 1.74 (95% CI 1.49 to 2.03) and DLR− was 0.50 (95% CI 0.38 to 0.65). The pooled DOR was 3.50 (95% CI 2.37 to 5.17). The area under the SROC curve was 0.68 (95% CI 0.64 to 0.72). The likelihood ratio scatter plot based on average sensitivity and specificity was in the lower right quadrant.ConclusionMeta-analysis results showed 18F-FDG PET/CT had low pooled sensitivity and specificity. The low DOR and the likelihood ratio scatter plot indicated that 18F-FDG PET/CT should be used with caution when predicting EGFR mutations in patients with NSCLC.

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“…[13][14][15][16][17][18][19] In contrary, some studies have reported that patients with higher SUVmax, with cutoffs from ≥6 to >13.65, were more likely to have EGFR mutations. [20][21][22] Our results are in favor that patients with higher SUVmax were more likely to have EGFR mutations. The discrepancy of these clinical studies maybe related to many factors such as different evaluation protocol and ethnicity/histopathologic type of included patients.…”

Section: Dovepressmentioning

confidence: 60%

“…Some reports showed that there was no difference between EGFR-mutants and wild-type lung cancers regarding SUVmax. 11,12 In contrast, other evidences indicated that patients with lower [13][14][15][16][17][18][19] or higher [20][21][22] SUVmax were more likely to have EGFR mutations.…”

Section: Introductionmentioning

confidence: 92%

Biological Significance of 18F-FDG PET/CT Maximum Standard Uptake Value for Predicting EGFR Mutation Status in Non-Small Cell Lung Cancer Patients

Wang

Han

Wang

et al. 2021

IJGM

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Purpose To investigate the potential of maximum standardized uptake value (SUVmax) in predicting epidermal growth factor receptor ( EGFR ) mutation status in non-small cell lung cancer (NSCLC) patients. Methods Clinical data of 311 NSCLC patients who had undergone both EGFR mutation test and 18 F-FDG PET/CT scans between January 2013 and December 2017 at our hospital were retrospectively analyzed. Patients were sub-grouped by their origin of SUVmax. Univariate and multivariate analyses were performed to investigate the association between clinical factors and EGFR mutations. Receiver operating characteristic curve (ROC) analysis was performed to confirm the predictive value of clinical factors. In vitro experiments were performed to confirm the correlation between EGFR mutations and glycolysis. Results EGFR -mutant patients had higher SUVmax than the wild-type patients in both primary tumors and metastases. In the multivariate analysis, SUVmax, gender and histopathologic type were determined as independent predictors of EGFR mutation status for patients whose SUVmax were obtained from the primary tumors; while for patients whose SUVmax were obtained from the metastases, SUVmax, smoking status and histopathologic type were regarded as independent predictors. ROC analysis showed that SUVmax of the primary tumors (cut off >10.92), not of the metastases, has better predictive value than other clinical factors in predicting EGFR mutation status. The predict performance was improved after combined SUVmax with other independent predictors. In addition, our in vitro experiments demonstrated that lung cancer cells with EGFR mutations have higher aerobic glycolysis level than wild-type cells. Conclusion SUVmax of the primary tumors has the potential to serve as a biomarker to predict EGFR mutation status in NSCLC patients.

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Contribution of18Fluorodeoxyglucose positron emission tomography uptake and TTF-1 expression in the evaluation of the EGFR mutation in patients with lung adenocarcinoma

Abstract: PET-CT FDG uptake may, together with TTF-1 expression, help diagnosis in lung adenocarcinoma cases when evaluating for EGFR mutation status.

Cited by 17 publications

References 37 publications

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Can¹⁸F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis

Biological Significance of 18F-FDG PET/CT Maximum Standard Uptake Value for Predicting EGFR Mutation Status in Non-Small Cell Lung Cancer Patients

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Contribution of18Fluorodeoxyglucose positron emission tomography uptake and TTF-1 expression in the evaluation of the EGFR mutation in patients with lung adenocarcinoma

Abstract: PET-CT FDG uptake may, together with TTF-1 expression, help diagnosis in lung adenocarcinoma cases when evaluating for EGFR mutation status.

Cited by 17 publications

References 37 publications

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Analysis of the clinicopathological characteristics, genetic phenotypes, and prognostic of pure mucinous adenocarcinoma

Can18F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis

Biological Significance of 18F-FDG PET/CT Maximum Standard Uptake Value for Predicting EGFR Mutation Status in Non-Small Cell Lung Cancer Patients

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Can¹⁸F-FDG PET/CT predict EGFR status in patients with non-small cell lung cancer? A systematic review and meta-analysis