肺腺癌中EGFR基因突变的肺部基础病变CT及临床特点

发布时间：2018-03-31 02:35

本文选题：EGFR突变　切入点：体层摄影术　出处：《临床放射学杂志》2017年12期

【摘要】：目的探讨肺腺癌中EGFR基因有效突变的肺部基础病变CT及临床的特点。方法搜集自2014年9月至2016年7月经过EGFR基因检测的具有完整临床及影像学资料的187例肺腺癌的病例,有效突变组67例,非有效突变组(对照组)120例,记录肺部基础病变CT影像特征及临床实验室血肿瘤标记物等情况,定量数据资料分析使用独立样本t检验或秩和检验;定性数据资料分析使用卡方检验或者Fisher确切概率法;对单因素分析差别有统计学意义的变量进行多因素Logistic回归分析,系统评价EGFR基因突变与肺部基础病变及临床实验室检查结果的关系。结果临床及实验室方面,EGFR有效突变组与对照组相比,女性好发(56.7%vs 35.0%,P=0.004)、低吸烟指数(平均秩次80.53 vs 101.52,P=0.007)、血肿瘤标记物CEA多发阳性(62.7%vs 37.5%,P=0.001)、C19少见阳性(14.9%vs 32.5%,P=0.009)。多元分析得出,EGFR基因有效突变多发生于女性(OR值2.328,95%CI1.169~4.636),血肿瘤标记物CEA多阳性(OR值4.337,95%CI 2.081~9.041),血肿瘤标记物C19少见阳性(OR值0.274,95%CI 0.114~0.659)。肺部基础病变CT特点,EGFR有效突变多伴轻度间质改变的磨玻璃密度影(40.3%vs 19.2%,OR值3.266,95%CI 1.497~7.125,P=0.002);少见"蜂窝征"(3%vs 18.3%,OR值0.182,95%CI 0.038~0.880,P=0.003)。结论 EGFR有效突变多发生于女性、低吸烟指数;血肿瘤标记物CEA阳性多发,C19阳性少见。EGFR有效突变多伴轻度间质改变中的磨玻璃密度影。"蜂窝征"为EGFR有效突变的保护因素,即CT影像发现"蜂窝征",EGFR有效突变几率小。
[Abstract]:Objective to investigate the CT and clinical features of lung basic lesions with effective mutation of EGFR gene in lung adenocarcinoma. Methods 187 cases of lung adenocarcinoma with complete clinical and imaging data from September 2014 to July 2016 were collected. There were 67 cases of effective mutation group and 120 cases of non-effective mutation group (control group, 120 cases). The CT imaging features of pulmonary basic diseases and the clinical laboratory blood tumor markers were recorded. The quantitative data were analyzed by independent sample t-test or rank sum test. The qualitative data were analyzed by chi-square test or Fisher exact probability method, and multivariate Logistic regression analysis was performed on the variables with statistical significance in univariate analysis. The relationship between the mutation of EGFR gene and pulmonary basic diseases and the results of clinical laboratory examination was systematically evaluated. Results the effective mutation of EGFR gene was compared with that of the control group in clinical and laboratory aspects. In women, 56.7 vs 35.0P0.004, low smoking index (mean 80.53 vs 101.52P0. 007), multiple positive CEA markers 62.7vs 37.5P0.001C19 infrequently positive 14.9 vs 32.5P0.0099.Multivariate analysis showed that the effective mutation of EGFR gene occurred in women with OR value of 2.3289595 CI 1.169C 4.63636. The OR value was 4.33795 CI 2.081C 9.041g, the rare positive OR value of blood tumor marker C19 was 0.27495 CI 0.114t 0.659.The CT features of pulmonary basic lesions were characterized by the effective mutation of EGFR-40.3% vs 19.2OR = 19.2OR = 19.2OR = 3.26695 CI 1.4977.125P0. 0020.The rare "honeycomb sign" 3vs 18.3i was OR 0.18295CI 0.0380.880P0. 003.Conclusion EGFR is effective. Mutations occur mostly in women, Low smoking index, rare and rare CEA positive multiple C19 positive mutations in blood tumor markers, most of them were associated with glass-grained densities in mild interstitial changes. "Honeycomb sign" was the protective factor of EGFR effective mutation. That is to say, the effective mutation probability of EGFR in honeycomb sign was small.
【作者单位】：天津市胸科医院放射科;
【分类号】：R730.44;R734.2

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