Background The correlation between epidermal growth factor receptor (EGFR) mutation status and histologic subtypes or characteristics of computed tomography findings in lung adenocarcinoma has been a research hotspot in recent years, and the results are various.
Objective To investigate the correlation between EGFR mutation and histologic subtypes or characteristics of computed tomography findings in patients with adenocarcinoma.
Methods Patients with pulmonary adenocarcinoma and ground-glass nodule (GGN) who underwent surgery from January 2018 to December 2019 were enrolled in this study. The patients were divided into mutation group (n=67, 21 males and 46 females) and wild-type group (n=27, 10 males and 17 females). Computed tomography (CT) findings, histologic subtypes, and EGFR mutation status were analyzed.
Results Totally 94 cases who were manifested as GGN preoperatively and with pathological results of lung adenocarcinoma postoperatively were included. The age of patients with EGFR mutation was significantly older than those with wild-type EGFR (58.61 ± 8.22 years vs 52.89 ± 10.45 years, P=0.006). The proportion of adenocarcinoma in the mutation group was higher than that in the wild-type group (91.0% vs 63.0%, P=0.001), while the proportion of lepidic predominant adenocarcinoma (LPA) subtype in the mutation group was significantly less than that in the wild-type group (38.8% vs 63%, P=0.033). Statistical difference was also found in visceral pleural invasion (44.8% vs 18.5%, P=0.017) and Ki-67 labeling index values (P=0.001). More concurrent TP53 mutation was found in the mutation group than that in the wild-type group (14.9% vs 0, P=0.030). By CT, a statistical significance was observed in the diameter of GGN (P=0.011) and the quantity of mixed GGN (mGGN) (85.1% vs 44.4%, P＜0.001). Less irregularity (28.4% vs 55.6%, P=0.013), lobulation (7.4% vs 44.8%, P=0.001), spiculation (25.9% vs 64.2%, P=0.001), vacuole (51.9% vs 76.1%, P=0.021), vessel convergence (18.5% vs 59.7%, P＜0.001) and air-bronchogram (11.1% vs 35.8%, P=0.017) were seen in the wild-type group than that in the mutation group. However, the CTR value of the mutation group was significantly higher than that in the wild-type group (P=0.003). According to ROC curve analysis, the EGFR mutation and the wild-type were identified by a critical value of 0.35, with a sensitivity of 71.6%, specificity of 70.4%, and the area under the ROC curve (AUC) of 0.708.
Conclusion Patients with larger GGN diameters, mGGN and CTR ≥ 0.35 are more likely to have EGFR mutations, and concurrent TP53 mutation is relatively frequent in these patients.
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