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- Title
Comparative analysis of clinicoradiologic characteristics of lung adenocarcinomas with ALK rearrangements or EGFR mutations.
- Authors
Zhou, J.; Zheng, J.; Yu, Z.; Xiao, W.; Zhao, J.; Sun, K.; Wang, B.; Chen, X.; Jiang, L.; Ding, W.
- Abstract
Objective: To compare the clinicoradiologic features of tumours with echinoderm anaplastic lymphoma kinase ( ALK) rearrangements, epidermal growth factor receptor ( EGFR) mutations, or wild type (WT) for both genes in a cohort of patients with lung adenocarcinoma to identify useful characteristics of different gene statuses. Methods: In 346 lung adenocarcinoma patients, ALK rearrangements were confirmed with fluorescence in situ hybridisation, and EGFR mutations were determined by pyrosequencing assay. Patients were divided into three groups: ALK rearrangement (ALK+ group, n = 48), EGFR mutation (EGFR+ group, n = 166), and WT for both genes (WT group, n = 132). Chest computed tomography (CT) examinations were performed in all patients. The percentages of ground-glass opacity volume (pGGO) and tumour shadow disappearance rate (TDR) were measured using semi-automated nodule assessment software. Results: The pGGO was significantly lower in the ALK+ group (25.1 % ± 24.3) than in the EGFR+ group (37.2 % ± 25.7, p < 0.001) and the WT group (36.1 % ± 24.6, p = 0.001). The TDR in the ALK+ group (17.3 % ± 25.1) was significantly lower than in the EGFR+ group (26.8 % ± 24.9, p = 0.002) and the WT group (25.7 % ± 24.6, p = 0.003). Conclusions: Solid pattern with lower incidence of lobulated border, finely spiculated margins, pleural retraction, and bubble-like lucency on CT imaging are the main characteristics of ALK rearrangement tumours. Key Points: • EGFR/ALK testing is recommended for lung adenocarcinoma patients for EGFR/ALK-targeted TKI therapy. • EGFR /ALK testing is restricted by limited tissue samples and cost pressures. • Lower pGGO and TDR are the main clinicoradiological characteristics of ALK+ tumours. • pGGO and TDR are predictive factors for selecting patients for ALK/EGFR testing.
- Subjects
ANAPLASTIC lymphoma kinase; EPIDERMAL growth factor receptors; LUNG cancer; ADENOCARCINOMA; CANCER genetics; COMPUTED tomography
- Publication
European Radiology, 2015, Vol 25, Issue 5, p1257
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-014-3516-z