I期非小细胞肺癌中的肿瘤空洞形成：表皮生长因子受体表达及预后不良预测

Tumor cavitation in stage I non-small cell lung cancer: epidermal growth factor receptor expression and prediction of poor outcome.

作者信息

Onn Amir, Choe Du Hwan, Herbst Roy S, Correa Arlene M, Munden Reginald F, Truong Mylene T, Vaporciyan Ara A, Isobe Takeshi, Gilcrease Michael Z, Marom Edith M

机构信息

Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 57, Houston, TX 77030, USA.

出版信息

Radiology. 2005 Oct;237(1):342-7. doi: 10.1148/radiol.2371041650.

DOI:10.1148/radiol.2371041650

PMID:16183941

Abstract

PURPOSE

To retrospectively identify radiographic characteristics of stage I non-small cell lung cancer (NSCLC) that may correlate with epidermal growth factor receptor (EGFR) or HER2 expression or with prognosis.

MATERIALS AND METHODS

This study was approved by the institutional review board, with waiver of informed consent, and was in compliance with HIPAA regulations. Findings of chest computed tomography (CT) were retrospectively evaluated in 72 patients who underwent resection of pathologic stage I NSCLC; tumor diameter, presence of calcifications, type of contour, type of margins, attenuation of the nodule, presence of a halo, presence of cavitation, and tumor location were documented. Immunohistochemical studies were performed in surgical specimens. Imaging and molecular data were correlated with patient outcome. Cox proportional hazards regression models were used to correlate biologic and radiographic variates with clinical outcome.

RESULTS

There were 38 men (53%) and 34 women (47%) (median age, 65.5 years). Median follow-up was 56.3 months; median overall survival, 76.3 months. A strong correlation was found between tumor diameter measured by radiologists and that measured by pathologists (P < .001; Pearson correlation coefficient, 0.81). EGFR overexpression was found in 48 (67%) tumors; significantly more was found in squamous cell carcinomas than was found in adenocarcinomas (P = .028), and more was found in T2 tumors than was found in T1 tumors (P = .001). HER2 overexpression was found in 13 (18%) tumors; cavitation, in 16 (22%) tumors. Cavitary lesions were significantly more common in squamous cell carcinomas than were in adenocarcinomas (P = .013) and in EGFR-overexpressing tumors (P = .012) than in tumors that did not overexpress EGFR. Cavitary lesions were significantly associated with shorter disease-free survival time (P = .01) and shorter overall survival time (P < .007).

CONCLUSION

Patients who have stage I NSCLC with cavitary lesions have an adverse prognosis and are likely to have tumor EGFR overexpression.

摘要

目的

回顾性确定可能与表皮生长因子受体（EGFR）或人表皮生长因子受体2（HER2）表达或预后相关的Ⅰ期非小细胞肺癌（NSCLC）的影像学特征。

材料与方法

本研究经机构审查委员会批准，豁免知情同意，并符合健康保险流通与责任法案（HIPAA）规定。对72例行病理Ⅰ期NSCLC切除术患者的胸部计算机断层扫描（CT）结果进行回顾性评估；记录肿瘤直径、钙化情况、轮廓类型、边缘类型、结节密度、晕征、空洞情况及肿瘤位置。对手术标本进行免疫组织化学研究。将影像学和分子数据与患者预后相关联。采用Cox比例风险回归模型将生物学和影像学变量与临床结局相关联。

结果

男性38例（53%），女性34例（47%）（中位年龄65.5岁）。中位随访时间56.3个月；中位总生存期76.3个月。放射科医生测量的肿瘤直径与病理科医生测量的肿瘤直径之间存在强相关性（P < .001；Pearson相关系数为0.81）。48例（67%）肿瘤发现EGFR过表达；鳞状细胞癌中的过表达显著多于腺癌（P = .028），T2肿瘤中的过表达多于T1肿瘤（P = .001）。13例（18%）肿瘤发现HER2过表达；16例（22%）肿瘤有空洞。空洞性病变在鳞状细胞癌中比在腺癌中更常见（P = .013），在EGFR过表达肿瘤中比在未过表达EGFR的肿瘤中更常见（P = .012）。空洞性病变与无病生存期缩短（P = .01）和总生存期缩短（P < .007）显著相关。