Zhu P, Xu XJ, Zhang MM, Fan SF. High-resolution computed tomography findings independently predict epidermal growth factor receptor mutation status in ground-glass nodular lung adenocarcinoma. World J Clin Cases 2021; 9(32): 9792-9803 [PMID: 34877318 DOI: 10.12998/wjcc.v9.i32.9792]
Corresponding Author of This Article
Shu-Feng Fan, PhD, Doctor, Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318 Chaowang Road, Gongshu District, Hangzhou 310005, Zhejiang Province, China. shufengfan16@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 16, 2021; 9(32): 9792-9803 Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9792
High-resolution computed tomography findings independently predict epidermal growth factor receptor mutation status in ground-glass nodular lung adenocarcinoma
Ping Zhu, Xiao-Jun Xu, Min-Ming Zhang, Shu-Feng Fan
Ping Zhu, Xiao-Jun Xu, Min-Ming Zhang, Shu-Feng Fan, Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, Zhejiang Province, China
Author contributions: Zhu P contributed to literature research, clinical studies, statistical analysis, manuscript preparation and editing; Xu XJ contributed to experimental studies/data analysis; Zhang MM was the guarantor of integrity of the entire study; Fan SF contributed to study concepts and design; all authors have read and approved the final manuscript.
Supported bythe Zhejiang Province Traditional Chinese Medicine Science and Technology Plan - Zhejiang Province Traditional Chinese Medicine Project for Traditional Chinese Medicine Scientific Research (2020) (Class B), No. 2020ZB117.
Institutional review board statement: This study was approved by the Ethics Committee of the Second Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang Province, China.
Informed consent statement: The individual consent was waived by the committee owing to the retrospective study design.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The data set supporting the results of this article are included within the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-Feng Fan, PhD, Doctor, Department of Radiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, No. 318 Chaowang Road, Gongshu District, Hangzhou 310005, Zhejiang Province, China. shufengfan16@126.com
Received: June 4, 2021 Peer-review started: June 4, 2021 First decision: June 25, 2021 Revised: July 30, 2021 Accepted: September 22, 2021 Article in press: September 22, 2021 Published online: November 16, 2021 Processing time: 158 Days and 16.3 Hours
ARTICLE HIGHLIGHTS
Research background
Applying high-resolution computerized tomography (HRCT) for lung cancer screening, previous studies have shown that certain imaging characteristics could predict epidermal growth factor receptor (EGFR) mutation status to a certain extent.
Research motivation
Non-invasive methods to predict EGFR mutations are of high importance but currently lacking. The value of HRCT in predicting EGFR mutations remains unclear.
Research objectives
This study aimed to assess the associations of EGFR mutations with HRCT features in ground-glass nodular lung adenocarcinoma.
Research methods
This study retrospectively assessed patients with ground-glass nodular lung adenocarcinoma diagnosed between January 2011 and March 2017. EGFR gene mutations in exons 18-21 were detected. The patients were classified into mutant EGFR and wild-type groups, and general data and HRCT image characteristics were assessed.
Research results
Among 98 patients, 31 (31.6%) and 67 (68.4%) had mutated and wild-type EGFR in exons 18-21, respectively. Gender, age, smoking history, location of lesions, morphology, edges, borders, pleural indentations, and associations of nodules with bronchus and blood vessels were comparable in both groups (all P > 0.05). Patients with mutant EGFR had larger nodules than those with the wild-type (17.19 ± 6.79 and 14.37 ± 6.30 mm, respectively; P = 0.047). Meanwhile, the vacuole/honeycomb sign was more frequent in the mutant EGFR group (P = 0.011). The logistic regression prediction model included the combination of nodule size and vacuole/honeycomb sign (OR = 1.120, 95%CI: 1.023-1.227, P = 0.014) revealed a sensitivity of 83.9%, a specificity of 52.2% and an AUC of 0.698 (95%CI: 0.589-0.806; P = 0.002).
Research conclusions
Nodule size and vacuole/honeycomb features could independently predict EGFR mutation status in ground-glass nodular lung adenocarcinoma.
Research perspectives
Future studies are warranted to confirm these findings and improve the non-invasive detection of EGFR gene mutations in lung cancer.
