Zhao Zi-Ya, Liu Si-Zhu, Chen Xue-Ping, Zhang Yang-Li, Fu Bin-Jie, Li Wang-Jia, Lv Fa-Jin, Chu Zhi-Gang
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
The Center for Clinical Molecular Medical detection, The First Affiliated Hospital of Chongqing Medical University, 1# Youyi Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
BMC Med Imaging. 2025 Aug 4;25(1):314. doi: 10.1186/s12880-025-01851-6.
Neoplastic ground glass nodules (GGNs) are relatively indolent tumors, with slow progression in invasiveness and computed tomography (CT) features. This study aimed to explore the correlation between pathological and CT characteristics and gene mutations in neoplastic GGNs.
We retrospectively analyzed 1,348 neoplastic GGNs from January 2019 to November 2022, including 290 adenocarcinomas in situ (AIS), 448 microinvasive adenocarcinomas (MIA), and 610 invasive adenocarcinomas (IAC). The correlations between patients' characteristics, pathological subtypes and grades, CT features, changes in follow-up, and gene mutations were analyzed.
Solid component (odds ratio [OR] = 1.493; P = 0.014), larger size (OR = 1.049; P = 0.006), ill-defined boundary (OR = 1.368; P = 0.027), and lobulation sign (OR = 1.824; P = 0.001) were revealed as independent CT predictors of gene mutation. From AIS to IAC, the epidermal growth factor receptor (EGFR) mutation rate significantly increased (P < 0.01), while the kirsten rat sarcoma viral oncogene (KRAS) and the anaplastic lymphoma kinase (ALK) mutation rates significantly decreased (P < 0.05). Among IACs, mutation rate was the highest in the intermediate-grade ones (P < 0.05). Gene mutations were more frequently detected in nodules showing changes during follow-up (76.3% vs. 61.1%, P = 0.02), especially in those with more than 2-year follow-up (77.1% vs. 43.7%, P = 0.023). However, the specific changes were not associated with gene mutations (P = 0.273).
Gene mutations in neoplastic GGNs were associated with CT features, pathological subtypes and grades, and changes observed during long-term follow-up.
肿瘤性磨玻璃结节（GGNs）是相对惰性的肿瘤，其侵袭性和计算机断层扫描（CT）特征进展缓慢。本研究旨在探讨肿瘤性GGNs的病理与CT特征及基因突变之间的相关性。
我们回顾性分析了2019年1月至2022年11月期间的1348个肿瘤性GGNs，包括290例原位腺癌（AIS）、448例微浸润腺癌（MIA）和610例浸润性腺癌（IAC）。分析了患者特征、病理亚型和分级、CT特征、随访变化与基因突变之间的相关性。
实性成分（优势比[OR]=1.493；P=0.014）、较大尺寸（OR=1.049；P=0.006）、边界不清（OR=1.368；P=0.027）和分叶征（OR=1.824；P=0.001）被揭示为基因突变的独立CT预测因素。从AIS到IAC，表皮生长因子受体（EGFR）突变率显著增加（P<0.01），而 Kirsten 大鼠肉瘤病毒癌基因（KRAS）和间变性淋巴瘤激酶（ALK）突变率显著降低（P<0.05）。在IAC中，中级别的突变率最高（P<0.05）。在随访期间出现变化的结节中更频繁地检测到基因突变（76.3%对61.1%，P=0.02），尤其是在随访超过2年的结节中（77.1%对43.7%，P=0.023）。然而，具体变化与基因突变无关（P=0.273）。
肿瘤性GGNs中的基因突变与CT特征、病理亚型和分级以及长期随访期间观察到的变化有关。
