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High incidence of EGFR mutations in pneumonic-type non-small cell lung cancer.

Liu J, Shen J, Yang C, He P, Guan Y, Liang W, He J - Medicine (Baltimore) (2015)

Bottom Line: Moreover, EGFR mutations were found in 39 of 52 P-LC patients (75%) and 263 of 542 non-P-LC NSCLC patients (48.5%).However, no difference was found on the mutation sites of EGFR.P-LC patients showed a significant higher incidence of EGFR mutations, which was independent of sex, histological type, and smoking history.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University (JL, JS, CY, PH, YG, WL, JH); Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease (JL, JS, CY, PH, YG, WL, JH); Department of Pathology (PH); and Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (YG).

ABSTRACT
To retrospectively identify computed tomography (CT) features that correlate with epidermal growth factor receptor (EGFR) mutation in surgically resected pneumonic-type lung cancer (P-LC). A total of 953 consecutive patients with surgically resected lung cancer in the First Affiliated Hospital of Guangzhou Medical University from August 2011 to August 2013 were studied. The CT manifestations were reevaluated independently by 2 radiologists. The presence of pneumonic-type consolidation with pathological confirmed non-small lung cancer (NSCLC) was defined as P-LC. EGFR mutation was determined by direct DNA sequencing or amplification refractory mutation system-PCR. EGFR mutation rates as well as clinical and pathological manifestations between P-LC and control lung cancer patients were compared. P-LC was diagnosed in 85 patients. Among these patients, 82 were adenocarcinoma (including 78 cases of invasive adenocarcinoma and 4 cases of microinvasive adenocarcinoma), 2 were squamous carcinoma and 1 was other type. P-LC occurred more frequently in female (58.8% vs 37.1%, P < 0.01), nonsmoking (76.5% vs 56.5%, P = 0.001) and adenocarcinoma (58.8% vs 37.1%, P < 0.01) patients. Moreover, EGFR mutations were found in 39 of 52 P-LC patients (75%) and 263 of 542 non-P-LC NSCLC patients (48.5%). However, no difference was found on the mutation sites of EGFR. Histological type, sex, and radiological manifestations (P-LC vs non-P-LC) but not smoking or sequencing method can be served as the independent predictor of EGFR mutations. P-LC patients showed a significant higher incidence of EGFR mutations, which was independent of sex, histological type, and smoking history. The patients with imaging manifestation of pneumonic-type consolidation are highly suggested to perform EGFR mutation analysis to guide the sequential treatment.

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Related in: MedlinePlus

CT images showing pneumonia-like consolidation (homogenous opacity) characterized by little or no loss of volume, effacement of blood-vessel shadows, and presence of an air bronchogram. CT = computed tomography.
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Figure 1: CT images showing pneumonia-like consolidation (homogenous opacity) characterized by little or no loss of volume, effacement of blood-vessel shadows, and presence of an air bronchogram. CT = computed tomography.

Mentions: All patients received a chest computed tomography (CT). Two radiologists independently interpreted CT images of P-LC without knowledge of EGFR status; any discrepancies were resolved by discussion until consensus was reached. Eighty-five patients with NSCLC were included according to following criteria: histologically or cytologically proven pulmonary carcinoma, in the absence of a prior diagnosis of thoracic or extrathoracic carcinoma; CT results showed a pneumonia-like consolidation, defined as an essentially homogenous opacity in the lung defined by little or no less volume, effacement of blood vessel shadows, and, sometimes, by the presence of an air bronchogram (Figure 1); and no concomitant bacterial pneumonia or obstructive pneumonia due to an exophytic lesion occluding the lumen of the main or lobar bronchi. Exclusion criteria were presence of lobe or lung atelectasis and presence of a prior diagnosis of thoracic adenocarcinoma in 5 years.


High incidence of EGFR mutations in pneumonic-type non-small cell lung cancer.

Liu J, Shen J, Yang C, He P, Guan Y, Liang W, He J - Medicine (Baltimore) (2015)

CT images showing pneumonia-like consolidation (homogenous opacity) characterized by little or no loss of volume, effacement of blood-vessel shadows, and presence of an air bronchogram. CT = computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554154&req=5

Figure 1: CT images showing pneumonia-like consolidation (homogenous opacity) characterized by little or no loss of volume, effacement of blood-vessel shadows, and presence of an air bronchogram. CT = computed tomography.
Mentions: All patients received a chest computed tomography (CT). Two radiologists independently interpreted CT images of P-LC without knowledge of EGFR status; any discrepancies were resolved by discussion until consensus was reached. Eighty-five patients with NSCLC were included according to following criteria: histologically or cytologically proven pulmonary carcinoma, in the absence of a prior diagnosis of thoracic or extrathoracic carcinoma; CT results showed a pneumonia-like consolidation, defined as an essentially homogenous opacity in the lung defined by little or no less volume, effacement of blood vessel shadows, and, sometimes, by the presence of an air bronchogram (Figure 1); and no concomitant bacterial pneumonia or obstructive pneumonia due to an exophytic lesion occluding the lumen of the main or lobar bronchi. Exclusion criteria were presence of lobe or lung atelectasis and presence of a prior diagnosis of thoracic adenocarcinoma in 5 years.

Bottom Line: Moreover, EGFR mutations were found in 39 of 52 P-LC patients (75%) and 263 of 542 non-P-LC NSCLC patients (48.5%).However, no difference was found on the mutation sites of EGFR.P-LC patients showed a significant higher incidence of EGFR mutations, which was independent of sex, histological type, and smoking history.

View Article: PubMed Central - PubMed

Affiliation: From the Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University (JL, JS, CY, PH, YG, WL, JH); Guangzhou Institute of Respiratory Disease and China State Key Laboratory of Respiratory Disease (JL, JS, CY, PH, YG, WL, JH); Department of Pathology (PH); and Department of Radiology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (YG).

ABSTRACT
To retrospectively identify computed tomography (CT) features that correlate with epidermal growth factor receptor (EGFR) mutation in surgically resected pneumonic-type lung cancer (P-LC). A total of 953 consecutive patients with surgically resected lung cancer in the First Affiliated Hospital of Guangzhou Medical University from August 2011 to August 2013 were studied. The CT manifestations were reevaluated independently by 2 radiologists. The presence of pneumonic-type consolidation with pathological confirmed non-small lung cancer (NSCLC) was defined as P-LC. EGFR mutation was determined by direct DNA sequencing or amplification refractory mutation system-PCR. EGFR mutation rates as well as clinical and pathological manifestations between P-LC and control lung cancer patients were compared. P-LC was diagnosed in 85 patients. Among these patients, 82 were adenocarcinoma (including 78 cases of invasive adenocarcinoma and 4 cases of microinvasive adenocarcinoma), 2 were squamous carcinoma and 1 was other type. P-LC occurred more frequently in female (58.8% vs 37.1%, P < 0.01), nonsmoking (76.5% vs 56.5%, P = 0.001) and adenocarcinoma (58.8% vs 37.1%, P < 0.01) patients. Moreover, EGFR mutations were found in 39 of 52 P-LC patients (75%) and 263 of 542 non-P-LC NSCLC patients (48.5%). However, no difference was found on the mutation sites of EGFR. Histological type, sex, and radiological manifestations (P-LC vs non-P-LC) but not smoking or sequencing method can be served as the independent predictor of EGFR mutations. P-LC patients showed a significant higher incidence of EGFR mutations, which was independent of sex, histological type, and smoking history. The patients with imaging manifestation of pneumonic-type consolidation are highly suggested to perform EGFR mutation analysis to guide the sequential treatment.

Show MeSH
Related in: MedlinePlus