周围型浸润性肺腺癌CT、病理表现与EGFR基因突变的相关性研究
发布时间：2018-10-11 12:03
【摘要】：目的:探讨周围型浸润性肺腺癌CT征象及病理特征与表皮生长因子受体(EGFR)基因突变状态的相关性。材料与方法:收集193例经病理证实为周围型浸润性肺腺癌患者的手术标本,采用扩增阻滞突变系统(ARMS)对所有标本行EGFR基因突变检测,结合患者胸部CT征象及病理资料行回顾性分析。结果:193例患者中EGFR基因突变率为62.2%(120/193)。在CT征象方面:EGFR基因突变患者与野生型患者于横轴位上肿瘤最大直径(Dmax)分别为(2.52±1.01)cm和(3.11±1.34)cm,两者差异有统计学意义,P0.05。ROC曲线提示Dmax=2.01cm为判断EGFR基因突变状态的最佳诊断阈值,敏感度与特异度分别为79%和64%。含磨玻璃密度影(GGO)的肿瘤突变率为78.0%(39/50),高于无GGO者(81/143,56.6%),P0.05。肿瘤不伴有囊腔样改变者突变率为65.5%(110/168),高于伴有囊腔样改变者(10/25,40.0%),P0.05。磨玻璃影/肿瘤直径比(G/T)、分叶征、毛刺征、胸膜凹陷征、血管集束征、空气支气管征、空泡征与EGFR基因突变率无显著相关性(P值均0.05)。在病理特征方面:组织学类型中以贴壁生长为主型浸润性腺癌突变率为77.5%(31/40),高于其它亚型(89/153,58.2%),P0.05。以实体生长为主型突变率为26.3%(5/19),低于其它亚型(115/174,66.1%),P0.05。无淋巴结转移者突变率为66.9%(91/136),高于淋巴结转移者(29/57,50.9%),P0.05。结论:在周围型浸润性肺腺癌中,部分CT征象及病理特征对于辅助预测EGFR基因突变状态具有一定价值,肿瘤于横轴位最大直径小于2.01cm、病灶内有GGO成分及不伴有囊腔样改变者突变率高,组织学分类上以贴壁生长为主型、无淋巴结转移患者中突变率高。
[Abstract]:Objective: to investigate the correlation between CT signs and pathological features of peripheral invasive lung adenocarcinoma and the mutation status of epidermal growth factor receptor (EGF) receptor (EGFR) gene. Materials and methods: 193 surgical specimens of peripheral invasive lung adenocarcinoma proved by pathology were collected. EGFR gene mutation was detected by amplification block mutation system (ARMS). Combined with chest CT signs and pathological data of the patients were retrospectively analyzed. Results: the mutation rate of EGFR gene was 62.2% (120 / 193) in 193 patients. In terms of CT signs, the maximum diameter (Dmax) of EGFR gene mutation patients and wild-type patients were (2.52 卤1.01) cm and (3.11 卤1.34) cm, respectively. P0.05.ROC curve indicated that Dmax=2.01cm was the best diagnostic threshold for EGFR gene mutation status. The sensitivity and specificity were 79% and 64%, respectively. The mutation rate of (GGO) with glass opacity was 78.0% (39 / 50), which was higher than that without GGO (81 / 143 / 56.6%). The mutation rate was 65.5% (110 / 168) in tumors without cystoid changes, higher than that in 10 / 25% (40.0%) patients with cystic changes (P0.05%). There was no significant correlation between G / T, lobulation sign, burr sign, pleural depression sign, vascular cluster sign, air bronchus sign, vacuole sign and mutation rate of EGFR gene (P < 0. 05). In pathological features, the mutation rate of adherent growth type invasive adenocarcinoma was 77.5% (31 / 40), which was higher than that of other subtypes (89 / 153 58.2%, P 0.05). The mutation rate of solid growth dominant type was 26.3% (5 / 19), which was lower than that of other subtypes (115 / 174 / 66.1%), P 0.05. The mutation rate in patients without lymph node metastasis was 66.9% (91 / 136), which was higher than that in patients with lymph node metastasis (29 / 57 / 50.9%) (P 0.05). Conclusion: in peripheral invasive lung adenocarcinoma, some CT signs and pathological features are useful in predicting the mutation status of EGFR gene. The maximum diameter of tumor in axial position was less than 2.01cm, and the mutation rate was high in the lesions with GGO components and no cystic cavity changes. The histopathological classification was mainly adherent growth type, and the mutation rate was high in the patients without lymph node metastasis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2
[Abstract]:Objective: to investigate the correlation between CT signs and pathological features of peripheral invasive lung adenocarcinoma and the mutation status of epidermal growth factor receptor (EGF) receptor (EGFR) gene. Materials and methods: 193 surgical specimens of peripheral invasive lung adenocarcinoma proved by pathology were collected. EGFR gene mutation was detected by amplification block mutation system (ARMS). Combined with chest CT signs and pathological data of the patients were retrospectively analyzed. Results: the mutation rate of EGFR gene was 62.2% (120 / 193) in 193 patients. In terms of CT signs, the maximum diameter (Dmax) of EGFR gene mutation patients and wild-type patients were (2.52 卤1.01) cm and (3.11 卤1.34) cm, respectively. P0.05.ROC curve indicated that Dmax=2.01cm was the best diagnostic threshold for EGFR gene mutation status. The sensitivity and specificity were 79% and 64%, respectively. The mutation rate of (GGO) with glass opacity was 78.0% (39 / 50), which was higher than that without GGO (81 / 143 / 56.6%). The mutation rate was 65.5% (110 / 168) in tumors without cystoid changes, higher than that in 10 / 25% (40.0%) patients with cystic changes (P0.05%). There was no significant correlation between G / T, lobulation sign, burr sign, pleural depression sign, vascular cluster sign, air bronchus sign, vacuole sign and mutation rate of EGFR gene (P < 0. 05). In pathological features, the mutation rate of adherent growth type invasive adenocarcinoma was 77.5% (31 / 40), which was higher than that of other subtypes (89 / 153 58.2%, P 0.05). The mutation rate of solid growth dominant type was 26.3% (5 / 19), which was lower than that of other subtypes (115 / 174 / 66.1%), P 0.05. The mutation rate in patients without lymph node metastasis was 66.9% (91 / 136), which was higher than that in patients with lymph node metastasis (29 / 57 / 50.9%) (P 0.05). Conclusion: in peripheral invasive lung adenocarcinoma, some CT signs and pathological features are useful in predicting the mutation status of EGFR gene. The maximum diameter of tumor in axial position was less than 2.01cm, and the mutation rate was high in the lesions with GGO components and no cystic cavity changes. The histopathological classification was mainly adherent growth type, and the mutation rate was high in the patients without lymph node metastasis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2
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