Epidermal Growth Factor Receptor Mutation Status in Stage I Lung Adenocarcinoma with Different Image Patterns

Hsu, Kuo-Hsuan; Chen, Kun Chieh; Yang, Tsung Ying; Yeh, Yi Chen; Chou, Teh Ying; Chen, Hsuan Yu; Tsai, Chia-Lung; Chen, Chih Yi; Hsu, Chiao Po; Hsia, Jiun-Yi; Chuang, Chun‐Yi; Tsai, Ying Huang; Chen, Kuan‐Yu; Huang, Ming Shyan; Su, Wu Chou; Chen, Yuh Min; Hsiung, Chao A.; Chang, Gee Chen; Chen, Chien Jen; Yang, Pan Chyr

doi:10.1097/jto.0b013e31821667b0

Cited by 43 publications

(43 citation statements)

References 46 publications

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“…Prior to 2010, the reported correlations between EGFR and KRAS mutations with GGO image patterns were tentative. With the emergence of large sample research (48), the majority of studies have reported that a low GGO component is associated with EGFR mutations or overexpression, which is consistent with the results of the present study; however, the association between KRAS mutations and radiological findings remains unclear.…”

Section: Discussionsupporting

confidence: 83%

“…In 2013, Lee et al (47) reported that tumors with a GGO proportion of >50% were less frequent among tumors with EGFR-overexpression compared with tumors without EGFR-overexpression in 214 patients with stage I NSCLC. Furthermore, in 2011, Hsu et al (48) retrospectively surveyed 162 patients with stage I lung adenocarcinoma with a tumor size of <3 cm, and found that the part-solid and solid pattern tumors had more typical EGFR mutations compared with the pGGO tumors. In 2012, Aoki et al (49) analyzed 25 lung adenocarcinomas of <3 cm in diameter and found a high incidence of EGFR mutations in the GGO-dominant lung adenocarcinomas; however, no correlation was observed between EGFR mutations and changes in the CT patterns.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Wang

Zhang

Han

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to compare pathological diagnoses, as determined by the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification, with conventional radiological features. In addition, the present study aimed to evaluate the correlation among clinical characteristics, computed tomography (CT) images and gene mutation status in patients with stage IA adenocarcinoma of the lung. A total of 212 patients with stage IA lung adenocarcinoma were included in the study. The patients were classified into pure ground-glass opacity (pGGO), mixed GGO (mGGO) and solid GGO (sGGO) by CT imaging. Histological subtype was classified according to the IASLC/ATS/ERS classification of lung adenocarcinoma. In addition, epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) mutation assays were performed, and 36.8% of patients (78/212) were determined to have an EGFR mutation, while 8.5% of patients (18/212) were found to have a KRAS mutation. According to the IASLC/ATS/ERS classification, 44 cases were diagnosed as adenocarcinoma in situ (AIS; 20.8%), 62 cases were diagnosed as minimally invasive adenocarcinoma (MIA; 29.2%) and 106 cases were classified as invasive adenocarcinoma (IAC; 50.0%). pGGO image patterns were observed in 39.2% of patients (n=83), while mGGO and sGGO patterns were observed in 28.8% (n=61) and 32.0% (n=68) of patients, respectively. From pGGO to sGGO, cases of AIS and MIA were shown to have a decreasing trend, while IAC cases exhibited an increasing trend (P=0.036). Analysis of the correlation between CT image patterns and gene mutations demonstrated that L858R point mutations, exon 19 deletions and KRAS mutations were more common in lesions with a lower GGO proportion (P=0.029, 0.027 and 0.018, respectively). Therefore, according to the IASLC/ATS/ERS classification, GGO imaging patterns were shown to correlate with subtypes of adenocarcinomas. In addition, EGFR and KRAS mutations were found to be associated with lesions with a low GGO proportion. Therefore, analysis of GGO lesions may offer useful indications of the histological subtype of an adenocarcinoma in patients with stage IA lung adenocarcinoma, and predictive value for EGFR and KRAS mutations.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Wang

Zhang

Han

et al. 2015

Experimental and Therapeutic Medicine

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“…Among them, 33 (45.8%) tumor lesions were found harboring EGFR mutations, and their founding indicated that there was a high discrepancy of driver mutations in NSCLC patients with ground-glass nodules (GGNs) (19). Another research showed that EGFR mutation especially L858R was detected more frequently in invasive solid pattern and significantly less in pure GGO pattern in stage I lung adenocarcinoma (21). In our study, 55 patient conducted EGFR detection, only 9 of them were pGGOs.…”

Section: Discussionmentioning

confidence: 99%

Correlation in histological subtypes with high resolution computed tomography signatures of early stage lung adenocarcinoma

Miao¹,

Zhang²,

Zou³

et al. 2017

Transl. Lung Cancer Res.

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“…To date, relatively few studies have investigated the relationships between CT imaging features with EGFR mutations (14)(15)(16)(17)(18)(19)(20). Most of these studies have focused on ground-glass opacity (GGO) ratio, and some of the findings are conflicting.…”

Section: Ct Image Interpretationmentioning

confidence: 99%

CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

Liu¹,

Kim²,

Qu³

et al. 2016

Radiology

190

178

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).q RSNA, 2016 Purpose:To retrospectively identify the relationship between epidermal growth factor receptor (EGFR) mutation status, predominant histologic subtype, and computed tomographic (CT) characteristics in surgically resected lung adenocarcinomas in a cohort of Asian patients. materials andMethods:This study was approved by the institutional review board, with waiver of informed consent. Preoperative chest CT findings were retrospectively evaluated in 385 surgically resected lung adenocarcinomas. A total of 30 CT descriptors were assessed. EGFR mutations at exons 18-21 were determined by using the amplification refractory mutation system. Multiple logistic regression analyses were performed to identify independent factors of harboring EGFR mutation status. The final model was selected by using the backward elimination method, and two areas under the receiver operating characteristic curve (ROC) were compared with the nonparametric approach of DeLong, DeLong, and Clarke-Pearson. Results:EGFR mutations were found in 168 (43.6%) of 385 patients. Mutations were found more frequently in (a) female patients (P , .001); (b)those who had never smoked (P , .001); (c)those with lepidic predominant adenocarcinomas (P = .001) or intermediate pathologic grade (P , .001); (e) smaller tumors (P , .001); (f) tumors with spiculation (P = .019), ground-glass opacity (GGO) or mixed GGO (P , .001), air bronchogram (P = .006), bubblelike lucency (P , .001), vascular convergence (P = .024), thickened adjacent bronchovascular bundles (P = .027), or pleural retraction (P , .001); and (g) tumors without pleural attachment (P = .004), a well-defined margin (P = .010), marked heterogeneous enhancement (P = .001), severe peripheral emphysema (P = .002), severe peripheral fibrosis (P = .013), or lymphadenopathy (P = .028). The most important and significantly independent prognostic factors of harboring EGFR-activating mutation for the model with both clinical variables and CT features were those who had never smoked and those with smaller tumors, bubblelike lucency, homogeneous enhancement, or pleural retraction when adjusting for histologic subtype, pathologic grade, or thickened adjacent bronchovascular bundles. ROC curve analysis showed that use of clinical variables combined with CT features (area under the ROC curve = 0.778) was superior to use of clinical variables alone (area under the ROC curve = 0.690). Conclusion:CT imaging features of lung adenocarcinomas in combination with clinical variables can be used to prognosticate EGFR mutation status better than use of clinical variables alone.q RSNA, 2016

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Epidermal Growth Factor Receptor Mutation Status in Stage I Lung Adenocarcinoma with Different Image Patterns

Cited by 43 publications

References 46 publications

Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Correlation in histological subtypes with high resolution computed tomography signatures of early stage lung adenocarcinoma

CT Features Associated with Epidermal Growth Factor Receptor Mutation Status in Patients with Lung Adenocarcinoma

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