Abstract
We aimed to develop a new EGFR mutation-predictive scoring system to use in screening for EGFR-mutated lung adenocarcinomas (lacs). The study enrolled 279 patients with lac, including 121 patients with EGFR wild-type tumours and 158 with EGFR-mutated tumours. The Student t-test, chi-square test, or Fisher exact test was applied to discriminate clinical and computed tomography (ct) features between the two groups. Using a principal component analysis (pca) model, we derived predictive coefficients for the presence of EGFR mutation in lac. The EGFR mutation-predictive score includes sex, smoking history, homogeneity, ground-glass opacity (ggo) on imaging, and the presence of pericardial effusion. The pca predictive model took this form: [Formula: see text]Model scores ranged from 79 to 147. The area under the receiver operating characteristic curve was 0.752 [95% confidence interval (ci): 0.697 to 0.801] in the lac population at the optimal cut-off value of 109, and the sensitivity and specificity were 68.4% (95% ci: 60.5% to 75.5%) and 74.4% (95% ci: 65.6% to 81.9%) respectively. The EGFR mutation risk scoring system based on clinical data and ct features is noninvasive and user-friendly. The model appears to frame a positive predictive value and was able to determine the value of repeating a biopsy if tissue is limited.
Highlights
The cancer-related lethality rate for lung and bronchus cancer is high worldwide, accounting annually for approximately 0.16 million deaths in the United States[1] and 0.61 million deaths in China[2]
The EGFR mutation risk scoring system based on clinical data and ct features is noninvasive and user-friendly
Patients were excluded if they had no computed tomography imaging data within 1 month before surgery; if they had no non-contrast ct data or contrast-enhanced ct data available; if pathology had confirmed that the lesion was not lac; if multiple tumours were present in the lung, such that the relationship between the tumour and the pathology results could not be independently determined; if tumour boundaries could not be distinguished; and if other types of mutations or the EGFR T790M mutation was present
Summary
The cancer-related lethality rate for lung and bronchus cancer is high worldwide, accounting annually for approximately 0.16 million deaths in the United States[1] and 0.61 million deaths in China[2]. Lung adenocarcinomas (lacs) represent a major proportion of the nsclc group[3]. Earlier studies have demonstrated that pathology classification has no significant effect on treatment and prognosis in most subtypes of nsclc (neuroendocrine tumours excepted)[4,5]. Increasing attention has been paid to the individual treatment of some particular lung cancer subtypes, among which the most studied is targeted therapy for lung cancer with gene mutations[6]. We aimed to develop a new EGFR mutation–predictive scoring system to use in screening for EGFR-mutated lung adenocarcinomas (lacs)
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