Correlation analysis between the maximum standard uptake value based on 18F-fluorodeoxyglucose PET-CT and the epidermal growth factor receptor mutation status of lung adenocarcinoma appearing as ground glass nodules
10.3760/cma.j.cn112149-20210615-00559
- VernacularTitle:表现为磨玻璃结节的肺腺癌表皮生长因子受体突变状态与 18F-脱氧葡萄糖摄取值的关系
- Author:
Yunmei SHI
1
;
Rong NIU
;
Xiaoliang SHAO
;
Jianxiong GAO
;
Xiaonan SHAO
;
Yuetao WANG
Author Information
1. 苏州大学附属第三医院 常州市第一人民医院核医学科 苏州大学核医学与分子影像临床转化研究所 常州市分子影像重点实验室，常州 213003
- Keywords:
Adenocarcinoma;
Lung;
Positron emission tomography;
Ground glass nodules;
Epidermal growth factor receptor
- From:
Chinese Journal of Radiology
2022;56(8):855-862
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between the maximum standard uptake value (SUV max) based on 18F-fluorodeoxyglucose (FDG) PET-CT and the epidermal growth factor receptor (EGFR) mutation status of lung adenocarcinoma appearing as ground glass nodules (GGN). Methods:A total of 103 patients with lung adenocarcinoma from October 2011 to December 2020 in the Third Affiliated Hospital of Soochow University were retrospectively enrolled. All patients underwent 18F-FDG PET-CT and high-resolution CT, and underwent surgical resection and EGFR detecting within one month. The patients were divided into EGFR mutation group and wild group according to the EGFR test results. The GGN number, type, location, shape, lobulation sign, spicule sign, abnormal bronchial sign, vacuole sign, pleural indentation, diameter of GGNs (D GGN), diameter of solid component (D solid) and nodule ground-glass opacity component CT mean (CT GGO) were analyzed on CT images. The maximum standard uptake value (SUV max) of nodules was measured on PET-CT images. The t test, Mann-Whitney U test or χ 2 test were used to compare the differences of clinical data, pathological data, CT imaging parameters and SUV max between the two groups. Hierarchical binary logistic regression model was used to assess whether there was any association between SUV max and EGFR mutation status in different subgroups. Generalized additive model and smooth curve fitting were applied to solve nonlinear problems, and piecewise binary logistic regression model was used to explain nonlinearity. Results:A total of 103 patients with 106 nodules were finally included. There were 75 patients (78 nodules) in the EGFR mutation group and 28 patients (28 nodules) in the EGFR wild group. Adenocarcinomas with EGFR mutation showed significantly higher spiculated edge, pleural depression sign and invasive adenocarcinoma proportions than those in EGFR wild group ( P<0.05). There were no significant differences in other indicators between groups ( P>0.05). After adjusting for age and fasting blood glucose, gender and the number of GGNs significantly affected the relationship between SUV max and EGFR mutation ( P<0.05), which suggested that there was an interaction. After adjusting for confounding factors, there was a non-linear relationship between SUV max and EGFR mutation status in female subgroup (degree of freedom was 1.817, P=0.026). When SUV max<2.4, the risk of EGFR mutation increased significantly with the increase of SUV max (OR=43.621, 95%CI 4.686-406.042), P<0.001]. When SUV max>2.4, the risk of EGFR mutation increased insignificantly ( P=0.392). Conclusions:Lung adenocarcinoma appearing as GGN has a higher risk of EGFR mutation. The risk of EGFR mutation in female patients increases with increasing SUV max, but there is saturation effect.
