摘要
目的：探究肺腺癌CT征象与表皮生长因子受体（EGFR）基因突变的相关性。方法回顾性分析2014年9月至2015年3月间203例经病理证实为肺腺癌患者CT资料，将突变情况根据这些位点与酪氨酸激酶抑制剂的疗效关系，分为有效突变组（97例）及非有效突变组（106例）。在所有的CT征象中，肿块直径采用秩和检验，密度采用Fisher精确概率法，其余征象（分叶征、毛刺征、坏死征、胸膜凹陷征、空洞征及空气支气管征）采用卡方检验对数据进行初步分析，再将有统计学意义的征象用logistic回归进行分析，计算优势比（OR）。结果在EGFR基因有效突变组，分叶征、毛刺征、坏死征、胸膜凹陷征分别为65、67、45、74例，非有效突变组对应的例数分别为56、51、26、61例，两组间差异具有统计学意义（χ^2值分别为4.230、9.141、10.646、7.986，P〈0.05）。病灶直径、密度、空洞征、空气支气管征在两组间差异没有统计学意义（P〉0.05）。Logistics回归分析显示：毛刺征（OR=2.120）、坏死征（OR=2.853）及胸膜凹陷征（OR=2.094）与EGFR有效突变有关（P〈0.05），而分叶征与EGFR有效突变无关。结论在所有的CT征象中，毛刺征、坏死征及胸膜凹陷征与EGFR基因有效突变有关，它们更容易出现在有EGFR基因有效突变的肺腺癌患者中。
Objective To explore the correlation between CT characters and epidermal growth factor receptor （EGFR） gene mutations in lung adenocarcinoma. Methods Two hundred and three lung adenocarcinoma patients （from September,2014 to March,2015） confirmed by pathology were divided into effective mutation group （97 cases） and non-effective mutation group （106 cases） on the basis of the site and the response to tyrosine kinase inhibitors. Among all the CT characters, rank-sum test was adopted to analyze the difference of diameter between the two groups; Fisher＇s exact test was applied to explain the difference of density type and Chi-square test was applied to analyze the difference of lobulation, spiculation, necrosis, pleural indentation, cavitation and air-brochogram signs. Logistic regression was used to analyze the significant signs and evaluate the odds ratio （OR）. Results There were 65, 67, 45, 74 cases of lobulation, spiculation, necrosis, pleural indentation in the EGFR gene effective mutation group and 56, 51, 26, 61 cases in non effective mutation group with statistically significant difference between the two groups （χ^2=4.230, 9.141, 10.646, 7.986, P〈0.05）. However, there were no significant difference between the two groups in the diameter, density, cavitation and air-brochogram （P〉0.05）. Logistics regression analysis showed that, spiculation （OR=2.120）, necrosis （OR=2.853） and pleural indentation （OR=2.094） were in correlation with EGFR effective mutations, and lobulation was not in correlation with EGFR effective mutations. Conclusions Among all the CT sings, spiculation, necrosis and pleural indentation were in correlation with EGFR gene effective mutation, they were more likely to appear in lung adenocarcinoma patients with EGFR gene effective mutation.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2016年第6期416-420,共5页
Chinese Journal of Radiology
关键词
肺肿瘤
受体
表皮生长因子
基因表达
体层摄影术
X线计算机
Lung neoplasms
Receptor, epidermal growth factor receptor
Gene expression
Tomography, X-ray computed
