Radiology Department, Memorial Sloan-Kettering Cancer Center, New York 10065, USA.
J Thorac Oncol. 2010 Mar;5(3):344-8. doi: 10.1097/JTO.0b013e3181ce9a7a.
To identify any particular imaging features on computed tomography (CT) in patients with confirmed adenocarcinoma with bronchioloalveolar (ABAC) features and known epidermal growth factor receptor (EGFR) and KRAS mutations.
Institutional review board approval was obtained for this retrospective study. Seventy-seven pulmonary nodules in 64 patients with a histologic diagnosis of ABAC and known EGFR or KRAS mutation status were assessed. Of these, 23 patients who were negative for both EGFR and KRAS mutations were used as a control group. Lesion size, margins, and density (ground glass versus solid) were assessed. Statistical analysis using the two-tailed Fisher's exact test t test was performed with multiple different variables.
Twenty-one (33%) of 64 patients had EGFR mutations, 20 (31%) of 64 patients had a KRAS mutation, and 23 (36%) had neither. In nine patients with an EGFR mutation, there were 10 nodules with some ground glass opacity (GGO) and in nine patients with a KRAS mutation, there were nine nodules with some GGO. Twenty-six (34%) of the 77 nodules had some GGO, and 12 (46%) of these 26 nodules were entirely GGO. Sixty-two (81%) of the 77 nodules had some solid component, which also included some that were mixed with GGO. Thirty-five (45%) of 77 nodules had air bronchograms. All five nodules (100%) with a high percentage of bronchioloalveolar carcinoma (>75%) had the appearance of GGO only. The presence of GGO on CT was not significantly associated with the presence of an EGFR mutation (p = 0.44) or with the presence of a KRAS mutation (p = 0.77).
In our sample of patients with ABAC, there was no specific CT appearance, which would correlate with either an EGFR mutation or a KRAS mutation, when compared with a control group of patients who did not have these mutations.
确定经组织学诊断为细支气管肺泡癌（BAC）且已知表皮生长因子受体（EGFR）和 KRAS 突变的患者的 CT 上是否存在特定的影像学特征。
本回顾性研究获得了机构审查委员会的批准。评估了 64 名经组织学诊断为 BAC 且已知 EGFR 或 KRAS 突变状态的患者的 77 个肺结节。其中，23 名 EGFR 和 KRAS 突变均为阴性的患者被用作对照组。评估了病变大小、边界和密度（磨玻璃影与实性）。使用双侧 Fisher 精确检验和 t 检验对多个不同变量进行了统计学分析。
64 名患者中有 21 名（33%）有 EGFR 突变，64 名患者中有 20 名（31%）有 KRAS 突变，23 名（36%）均无突变。在 9 名 EGFR 突变患者中，有 10 个结节有部分磨玻璃密度影（GGO），在 9 名 KRAS 突变患者中，有 9 个结节有部分 GGO。77 个结节中有 26 个（34%）有部分 GGO，其中 12 个（46%）为完全 GGO。77 个结节中有 62 个（81%）有部分实性成分，其中还包括部分混合性 GGO。77 个结节中有 35 个（45%）有空气支气管征。所有 5 个（100%）高比例细支气管肺泡癌（>75%）的结节仅表现为 GGO 外观。CT 上的 GGO 存在与 EGFR 突变（p=0.44）或 KRAS 突变（p=0.77）均无显著相关性。
在我们的 BAC 患者样本中，与未发生这些突变的对照组患者相比，没有特定的 CT 表现与 EGFR 突变或 KRAS 突变相关。
