非小细胞肺癌CT影像征象及临床特征与EGFR基因突变的相关性

Study on the correlation between CT imaging signs as well as clinical features and EGFR gene mutations in non-small cell lung cancer

【目的】分析并探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)患者胸部CT影像征象及部分临床特征与表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变之间的相关性。【方法】选择2015年12月至2017年12月我院就诊肺癌患者,共筛选出86例病理证实为NSCLC的患者。所有患者行胸部CT检查、活检病理诊断及EGFR基因检测。定性分析所有患者胸部CT上病灶所在肺叶、位置、形状、边界、密度、空气支气管征、肺内转移、磨玻璃影、胸膜牵拉、胸腔积液、肺气肿、肺间质纤维化等影像征象,统计患者的病理类型、EGFR基因突变型、野生型数量,同时记录性别、年龄及吸烟情况,通过统计分析以上CT影像特征、患者性别、年龄、吸烟情况及EGFR基因突变状态,评估NSCLC患者CT影像特征、患者性别、年龄及吸烟情况与EGFR基因突变之间的联系。【结果】胸膜牵拉、肺气肿、性别及是否吸烟与NSCLC患者EGFR基因突变间差异有统计学意义(P<0.05)。【结论】胸膜有牵拉、肺内无肺气肿、女性、无吸烟患者可作为非小细胞肺癌EGFR基因突变的预测因素。

[Objective] To explore the correlation between CT imaging signs as well as clinical features and epidermal growth factor receptor （EGFR） gene mutations in non-small cell lung cancer （NSCLC）. [Methods] A total of 86 patients with NSCLC confirmed by pathology were screened out from December 2015 to December 2017 in our hospital. All the patients underwent chest CT, biopsy pathological diagnosis and EGFR gene mutations. Qualitative evaluation of CTs was performed in lobe, location, shape, margins, density, air bronchogram, intrapulmonary metastasis, ground-glass opacity, pleural retraction, pleural effusion, emphysema and fibrosis. Pathological types, EGFR gene mutations, wild type quantity, sex, age and smoking history of every patient were recorded. Statistical analysis was performed to assess the association of the features with each gene mutation. [ Results ] EGFR mutation was associated with pleural retraction, absence of emphysema, females and non-smokers （P〈0.05）. [Conclusion] Pleural retraction, absence of emphysema, females and non-smokers may be used as predictive factors for EGFR gene mutations in non-small cell lung cancer.