胸部CT在预测周围型浸润性肺腺癌EGFR基因突变中的应用研究  

Application of Chest CT in predicting EGFR Gene Mutations in peripheral infiltrating Lung Adenocarcinoma

作　　者：邢德明 黄琳[2] 程瑞学[3] XING Deming;HUANG Lin;CHENG Ruixue(Radiology Department,Dengzhou Center for Disease Control and Prevention,Dengzhou Henan 474150,China;Radiology Department,Xinxiang Central Hospital,Xinxiang Henan 453000,China;MRI Room,Xinxiang Central Hospital,Xinxiang Henan 453000,China)

机构地区：[1]邓州市疾病预防控制中心放射科,河南邓州474150 [2]新乡市中心医院放射科,河南新乡453000 [3]新乡市中心医院磁共振室,河南新乡453000

出　　处：《临床研究》2024年第4期140-143,共4页Clinical Research

摘　　要：目的分析胸部计算机断层扫描(CT)在预测周围型浸润性肺腺癌表皮生长因子受体(EGFR)基因突变中的应用价值。方法选取邓州市疾病预防控制中心2020年1月到2023年2月的462例周围型浸润性肺腺癌患者实施胸部CT检测,对比不同组织学亚型(贴壁为主型、腺泡为主型、乳头为主型、微乳头为主型、实体为主型)的EGFR基因突变状态、胸部CT图像特征(部位、形态、磨玻璃密度影、最大直径、磨玻璃密度影中瘤直径比、空泡征、支气管充气征、毛刺、肿瘤不伴有囊腔样改变),并应用Logistic回归分析胸部CT影像特征与EGFR基因突变的相关性。结果本组EGFR基因突变共计180例(突变组),野生型共计282例(野生组),通过分析组织学亚型与EGFR基因突变状态的相关性显示,突变组中贴壁为主型占比显著高于野生组,差异具有统计学意义(P<0.05),其它类型比较差异无统计学意义(P>0.05)。通过分析胸部CT检查结果显示,野生组具有磨玻璃密度影占比显著高于突变组,肿瘤不伴有囊腔样改变占比显著低于突变组,差异均有统计学意义(P<0.05)。Logistic回归分析结果表明,具有磨玻璃密度影、肿瘤不伴有囊腔样改变对于预测EGFR基因突变具有非常重要的临床价值。结论胸部CT可较为准确的预测周围型浸润性肺腺癌EGFR基因突变。Objective To analyze the application value of chest computed tomography(CT)in predicting epidermal growth factor receptor(EGFR)gene mutations in peripheral invasive lung adenocarcinoma.Methods A total of 462 patients with peripheral infiltrating lung adenocarcinoma in our hospital from January 2020 to February 2023 were selected for chest CT examination.The EGFR gene mutation patterns of different histological subtypes(adherent as the main type,acinar as the main type,papillary as the main type,micropapillary as the main type,and solid as the main type)and Chest CT image features(location,morphology,ground glass density shadow,maximum diameter,tumor diameter ratio in ground glass density shadow,vacuolar sign,bronchial inflation sign,spiculation,and tumor without cystic changes)were compared,and the Logistic regression analysis was applied to investigate the correlation between chest CT image features and EGFR gene mutations.Results There were a total of 180 cases of EGFR gene mutations in this group(mutation group)and 282 cases of wild-type mutations(wild-type group).By analyzing the correlation between histological subtypes and EGFR gene mutation status,it was found that the proportion of adherent dominant types in the mutation group was significantly higher than that in the wild-type group,and the difference was statistically significant(P<0.05),while there was no statistically significant difference in other types(P>0.05).The analysis of chest CT examination results showed that the proportion of ground glass density shadows in the wild group was significantly higher than that in the mutant group,and the proportion of tumors without cystic changes was significantly lower than that in the mutant group,with statistical significance(P<0.05).The results of Logistic regression analysis indicate that having ground glass density shadows and tumors without cystic changes have significant clinical value in predicting EGFR gene mutations.Conclusion Chest CT can accurately predict EGFR gene mutations in peripheral invasiv

关 键 词：胸部CT 周围型浸润性肺腺癌 EGFR 基因突变 

分 类 号：R563[医药卫生—呼吸系统]