Department of Respiratory Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Internal Medicine, Mihara Medical Association Hospital, 1-15-1 Miyaura, Mihara, 723-0051, Japan.
BMC Pulm Med. 2022 Jun 30;22(1):260. doi: 10.1186/s12890-022-02037-4.
Mesenchymal-epithelial transition exon14 (METex14) skipping is one of the therapeutic driver oncogene mutations in non-small cell lung cancer (NSCLC), and can be treated with tepotinib and capmatinib. There is only one report on computed tomography (CT) findings of METex14 skipping-positive NSCLC, which shows that the primary tumor tends to have a large mass in the upper lobe, and extrathoracic metastases are common. This study examined the CT findings of METex14 skipping-positive NSCLC, focusing on the features of the margins and internal structures.
We consecutively included patients with METex14 skipping-positive NSCLC who were diagnosed between January 2018 and December 2020 at four independent institutions. We retrospectively reviewed the patient demographics and CT findings for tumor margins (invasion into surrounding tissue, lobulation, pleural indentation, spicula, and ground-glass opacity) and internal structures (air bronchograms, cavitation and internal low-density area).
Fifteen patients with METex14 skipping-positive NSCLC were identified. Almost half of the patients were men (7/15; 46.7%), and their median age was 75.0 years. More than half were either current or former smokers (9/15; 60.0%). A vast majority of histological subtypes were adenocarcinoma (10/15; 66.7%), followed by pleomorphic carcinoma (3/15; 20.0%) and squamous cell carcinoma (2/15; 13.3%). With regard to CT findings, most primary tumors presented as masses larger than 30 mm (12/15; 80.0%) and were located in the upper lobes (12/15; 80.0%). Invasion into surrounding tissue and presence of internal low-density areas were observed in 60.0% (9/15) and 66.7% (10/15) of the primary tumors, respectively. Additionally, their frequencies increased to 72.7% (8/11) and 90.9% (10/11) in stage III/IV cases, respectively. In lymph node metastasis, internal low-density areas were observed in 8/10 cases (80.0%). Although these two CT features were rarely observed in distant metastases at diagnosis, they became apparent with progression of the metastatic tumor size.
METex14 skipping-positive NSCLC tumors tend to invade surrounding tissue and possess internal low-density areas. These CT findings might be characteristic of METex14 skipping-positive NSCLC.
间质-上皮转化外显子 14（METex14）跳跃是非小细胞肺癌（NSCLC）的治疗驱动基因突变之一，可采用 tepotinib 和 capmatinib 进行治疗。目前仅有一篇关于 METex14 跳跃阳性 NSCLC 的 CT 表现的报告，该报告显示，原发性肿瘤在上叶往往体积较大，且常发生胸外转移。本研究通过 CT 检查观察 METex14 跳跃阳性 NSCLC 的表现，重点关注肿瘤边缘和内部结构的特征。
我们连续纳入了 2018 年 1 月至 2020 年 12 月在 4 家独立机构确诊的 METex14 跳跃阳性 NSCLC 患者。我们回顾性分析了患者的人口统计学数据和 CT 检查结果，包括肿瘤边缘（侵犯周围组织、分叶、胸膜凹陷、刺突和磨玻璃影）和内部结构（空气支气管征、空洞和内部低密度区）。
共纳入 15 例 METex14 跳跃阳性 NSCLC 患者。其中近一半为男性（7/15；46.7%），中位年龄为 75.0 岁。超过一半的患者为现吸烟者或既往吸烟者（9/15；60.0%）。绝大多数组织学类型为腺癌（10/15；66.7%），其次为多形性癌（3/15；20.0%）和鳞状细胞癌（2/15；13.3%）。就 CT 表现而言，大多数原发性肿瘤的直径大于 30mm（12/15；80.0%），且位于上叶（12/15；80.0%）。侵犯周围组织和存在内部低密度区分别见于 60.0%（9/15）和 66.7%（10/15）的原发性肿瘤，这两种表现的频率在 III/IV 期病例中分别增加至 72.7%（8/11）和 90.9%（10/11）。在淋巴结转移中，内部低密度区见于 8/10 例（80.0%）。尽管这两种 CT 特征在诊断时远处转移中很少见，但随着转移性肿瘤大小的进展，这些特征变得明显。
METex14 跳跃阳性 NSCLC 肿瘤倾向于侵犯周围组织并具有内部低密度区。这些 CT 表现可能是 METex14 跳跃阳性 NSCLC 的特征。
