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目的:探讨周围型非小细胞肺癌(PNSCLC)的CT特征与表皮生长因子受体(EGFR)基因突变的关系。方法:选择我院初治的PNSCLC 60例,均具有完整的临床资料,并经组织病理学检查证实。所有入组病例的组织学或细胞学标本,均使用扩增阻滞突变系统(ARMS)法或基因测序法进行EGFR基因突变状态检测。结合每例患者胸部影像学检查情况评估CT特征与EGFR基因突变的关系。结果:本组PNSCLC 60例中,发生EGFR基因突变29例,其中女性占53.3%,无吸烟史者占55.6%。EGFR基因突变者病灶CT增强幅值(49.07±12.57)Hu,无EGFR基因突变者为(38.43±13.93)Hu;两者比较,差异非常显著(P<0.01)。在伴CT血管集束征、胸膜凹陷征、骨转移征PNSCLC中,EGFR基因突变率与无EGFR基因突变率分别为33.3%、66.7%;38.5%、61.5%;70.6%、29.4%;两两比较,均差异显著(P<0.05)。在伴CT深分叶征、细短毛刺征、胸腔积液及其他转移征象PNSCLC中,EGFR基因突变率与无EGFR基因突变率均差异不显著(P>0.05)。结论:在PNSCLC中,EGFR基因突变者病灶CT增强幅值显著增高;伴骨转移肿瘤EGFR基因突变率较高,伴胸膜凹陷征、血管集束征肿瘤EGFR基因突变率较低。
Objective: To investigate the relationship between CT features and epidermal growth factor receptor (EGFR) gene mutation in peripheral non-small cell lung cancer (PNSCLC). Methods: Sixty patients with newly diagnosed PNSCLC in our hospital were selected. All of them had complete clinical data and were confirmed by histopathological examination. Histological or cytological specimens of all enrolled patients were tested for EGFR gene mutation using the ARMS or gene sequencing method. The relationship between CT features and EGFR gene mutations was evaluated with chest radiography in each patient. Results: There were 29 cases of EGFR gene mutations in 60 cases of PNSCLC in this group, of which 53.3% were women and 55.6% were without smoking history. The lesions of patients with EGFR gene mutations (49.07 ± 12.57) Hu and those without EGFR gene mutations were (38.43 ± 13.93) Hu. The difference between the two groups was significant (P <0.01). In PNSCLC with CT clustering, pleural indentation and bone metastasis, the mutation rates of EGFR gene and non-EGFR gene were 33.3%, 66.7%, 38.5%, 61.5%, 70.6%, 29.4%, respectively , All significant differences (P <0.05). In PNSCLC with CT deep lobulation sign, short and short burr sign, pleural effusion and other metastatic signs, the mutation rates of EGFR gene and non-EGFR gene were not significantly different (P> 0.05). CONCLUSION: In PNSCLC, the amplitudes of CT enhancement in patients with EGFR gene mutation are significantly higher. The mutation rate of EGFR gene in patients with bone metastasis is higher, and the mutation rate of EGFR gene in patients with pleural indentation and vascular bundles is lower.