Author of

• 12791

  +

  P3.19 - Poster Session 3 - Imaging (ID 181)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12811

    +

    P3.19-020 - Multivariable analysis of the high resolution-CT findings of the presence or absence of epidermal growth factor receptor mutation for 476 primary lung adenocarcinomas (ID 1589)

    09:30 - 09:30  |  Author(s): H. Nakayama
    • Abstract

    Background
    The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor make very important role in chemotherapy for primary lung adenocarcinoma. It is necessary to examine EGFR mutation before medication, but it is difficult to examine for all patients. Our purpose is to determine EGFR mutation presence by HRCT findings of primary lung adenocarcinoma.

    Methods
    This study consists of 476 primary lung adenocarcinomas which were examined EGFR mutation (exon 18, 19 and 21) by a genetic analysis. EGFR mutation-positive group (EGFR-P) were 223 cases (resected =178, non-resected =45), and EGFR wild-type group (EGFR-W) were 253 cases (resected =161, non-resected =92). At first, presence of findings, such as much pleural effusion, atelectasis, or secondary pneumonia, that come to have difficulty in evaluation of size and the character of tumor, was determined. Then, all evaluable parameters were analyzed. The high resolution-CT (HRCT) findings that were analyzed independently by 2 radiologists with special attention were 21 parameters (tumor size, well-defined margin, irregular margin, spiculation, lobulation, pure ground-glass opacity (GGO), part-solid, solid, air bronchogram, cavity, calcification, broncho-vascular convergence, pleural indentation, pleural concave, pleural thickness, lymphangitis carcinomatosis, emphysema, interstitial pneumonia, pulmonary metastasis, pleural effusion, and lymph node enlargement). The age, gender and smoking history were additionally reviewed. These parameters were evaluated with Chi square test and multivariate analysis. A p-value less than 0.01 were considered to indicate a statistically significant difference.

    Results
    The cases that were hard to analyze a tumor into by such as atelectasis were two (EGFR-P) and 26 (EGFR-W), respectively. A statistical significant difference was present (p=3.4E-05). Chi square test showed a statistically significant difference about "part-solid (p=5.5E-06)", "air bronchogram (p=0.0036)" and "pleural indentation (p=0.0002)" more frequently in EGFR-P than in EGFR-W. Similarly “woman (p=1.3E-09)” and “non-smoker (p=2.7E-13)” were observed more frequently in EGFR-P than in EGFR-W. On the other hand, “solid (p=2.1E-07)”, “cavity (p=0.0004)”, “emphysema (p=5.1E-14)”, “interstitial pneumonia (p=3.1E-8)” and “lymph node enlargement (p=0.0008)” were observed more frequently in EGFR-W than in EGFR-P. And Multivariable analysis showed that “cavity (p=0.003)”, “emphysema (p=0.001)” and “interstitial pneumonia (p=0.001)” were observed more frequently in EGFR-W than in EGFR-P. On the other hand, there was no parameter that became statistically significantly more frequently in EGFR-P than EGFR-W. By the multivariable analysis, there was no significant statistical difference about gender and smoking history.

    Conclusion
    The cases that were hard to analyze a tumor into by such as atelectasis were significant in EGFR-W. Some HRCT findings (part-solid, solid, air bronchogram, cavity, pleural indentation, emphysema and interstitial pneumonia) indicated more statistically significant usefulness for a diagnosis of the EGFR mutation. Especially multivariable analysis showed that HRCT findings (cavity, emphysema and interstitial pneumonia) were more statistically significant about EGFR mutation than gender and smoking history.