Relationship between the epidermal growth factor receptor gene mutation and malignant pulmonary focal ground-glass lesion_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Mingdong ,  ZHAO Xuewei

Department of Cardiothoracic Surgery, Changzheng Hospital, The Second Military Medical University, Shanghai, 200003, P.R.China;

Corresponding?author：

ZHAO Xuewei, Email: xuewei_zhao@hotmail.com

Keywords：

Epidermal growth factor receptor gene mutation; focal ground-glass lesion; ground-glass nodule; lung cancer

DOI：

10.7507/1007-4848.201610051

Video：

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Objective To analyze the relationship between the epidermal growth factor receptor(EGFR) gene mutation and malignant pulmonary focal ground-glass lesion (fGGL). Methods We retrospectively collected the clinical data of 86 patients with surgical treatment in the department of cardiothoracic surgery of Changzheng Hospital from August 2012 to February 2015. There were 26 males and 60 females with a mean age of 56.14±10.55 years. We analyzed the relationship between the EGFR gene mutation and the related clinical data. Results Postoperative pathology showed atypical adenomatous hyperplasia (AAH) combined with focal adenocarcinoma in situ (AIS) or AIS in 10 patients, minimally invasive adenocarcinoma (MIA) in 15, and lepidic predominant adenocarcinoma (LPA) in 61. The EGFR gene mutation reports showed the exon 19 19-del mutation in 14 patients, exon 21 L858R mutation in 27, and exon 21 L861Q mutation in 2. There was no difference between the mutation of EGFR gene and clinical factors except age and smoking (P>0.05). Till June 30, 2015, all patients were alive and follow-up was 440.48±186.61 days. Conclusion The EGFR gene in patients with malignant pulmonary fGGL shows a higher mutation rate, which provides important clinical reference data for the basic research and the clinical treatment.

Citation： WANG Mingdong, ZHAO Xuewei. Relationship between the epidermal growth factor receptor gene mutation and malignant pulmonary focal ground-glass lesion. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(9): 711-715. doi: 10.7507/1007-4848.201610051 Copy

1.	中華醫學會放射學會分會心胸學組. 肺亞實性結節影像處理專家共識. 中華放射學雜志, 2015, 49(4): 254-258.
2.	Scagliotti GV, Selvaggi G, Novello S, et al. The biology of epidermal growth factor receptor in lung cancer. Clin Cancer Res, 2004, 10(3): 4227-4232.
3.	郭天興, 潘小杰, 歐德彬, 等. 表現為磨玻璃樣病變的肺腺癌臨床特點與 EGFR 及 K-RAS 基因突變的關系. 腫瘤防治研究, 2014, 41(12): 1313-1317.
4.	蔣慧, 武春燕. 上海肺科醫院 110 例肺部磨玻璃樣結節臨床診治分析. 臨床肺科雜志, 2016, 21(2): 239-241.
5.	Lim HJ, Ahn S, Lee KS, et al. Persistent pure ground-glass opacity lung nodules ≥10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications. Chest, 2013, 144(4): 1291-1299.
6.	Cho S, Yang H, Kim K, et al. Pathology and prognosis of persistent stable pure ground-glass opacity nodules after surgical resection. Ann Thorac Surg, 2013, 96(4): 1190-1195.
7.	Lee HY, Choi YL, Lee KS, et al. Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management. AJR Am J Roentgenol, 2014, 202(3): 224-233.
8.	汪金錢. 肺部局限性 GGO 的影像學診斷方法及外科處理策略. 臨床肺科雜志, 2013, 18(6):1104-1105.
9.	曹曉明, 鄧朝勝, 林其昌, 等. 肺部磨玻璃樣病變的診治進展. 中華結核和呼吸雜志, 2015,38(4): 298-301.
10.	Matsuguma H, Mori K, Nakahara R, et al. Characteristics of subsolid pulmonary nodules showing growth during follow-up with CT scanning. Chest, 2013, 143(2): 436-443.
11.	Kobayashi Y, Fukui T, Ito S, et al. How long should small lung lesions of ground-glass opacity be followed? J Thorac Oncol, 2013, 8(3): 309-314.
12.	Yoshida J, Nagai K, Yokose T, et al. Limited resection trial for pulmonary ground-glass opacity nodules: fifty-case experience. J Thorac Cardiovasc Surg, 2005, 129(5): 991-996.
13.	Haneda H, Sasaki H, Lindeman N, et al. A correlation between EGFR gene mutation status and bronchioloalveolar carcinoma features in japanese patients with adenocarcinoma. Jpn J Clin Oncol, 2006, 6(3): 69-75．.
14.	Stabile LP, Lyker JS, Gubish CT, et al. Combined targeting of the estrogen receptor and the epidermal growth factor receptor in non-small cell lung cancer shows enhanced antiproliferative eff ects. Cancer Res, 2005, 65(4): 1459-1470.
15.	Chung JH, Choe G, Jheon S, et al. Epidermal growth factor receptor mutation and pathologic-radiologic correlation between multiple lung nodules with ground-glass opacity differentiates multicentric origin from intrapulmonary spread. J Thorac Oncol, 2009, 4(12): 1490-1495.
16.	喬文亮, 林強. 肺內磨玻璃影的分子生物學研究進展. 中國肺癌雜志, 2014, 24(3): 235-240.
17.	Yoshida J. Management of the peripheral small ground-glass opacities. Thorac Surg Clin, 2007, 17(2): 191-201.
18.	毛海霞, 韓砆石, 項文靜, 等. 肺腺癌局灶性磨玻璃影的診斷與處理. 中華結核和呼吸雜志, 2015, 38(7): 535-537.
19.	Song YS, Park CM, Park SJ, et al. Volume and mass doubling times of persistent pulmonary subsolid nodules detected in patients without known malignancy. Radiology, 2014, 273(1): 276-284.
20.	Hasegawa M, Sone S, Takashima S, et al. Growth rate of small lung cancers detected on mass CT Screening. Br J Radiol, 2000, 73(876): 1252-1259.

1. 中華醫學會放射學會分會心胸學組. 肺亞實性結節影像處理專家共識. 中華放射學雜志, 2015, 49(4): 254-258.
2. Scagliotti GV, Selvaggi G, Novello S, et al. The biology of epidermal growth factor receptor in lung cancer. Clin Cancer Res, 2004, 10(3): 4227-4232.
3. 郭天興, 潘小杰, 歐德彬, 等. 表現為磨玻璃樣病變的肺腺癌臨床特點與 EGFR 及 K-RAS 基因突變的關系. 腫瘤防治研究, 2014, 41(12): 1313-1317.
4. 蔣慧, 武春燕. 上海肺科醫院 110 例肺部磨玻璃樣結節臨床診治分析. 臨床肺科雜志, 2016, 21(2): 239-241.
5. Lim HJ, Ahn S, Lee KS, et al. Persistent pure ground-glass opacity lung nodules ≥10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications. Chest, 2013, 144(4): 1291-1299.
6. Cho S, Yang H, Kim K, et al. Pathology and prognosis of persistent stable pure ground-glass opacity nodules after surgical resection. Ann Thorac Surg, 2013, 96(4): 1190-1195.
7. Lee HY, Choi YL, Lee KS, et al. Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management. AJR Am J Roentgenol, 2014, 202(3): 224-233.
8. 汪金錢. 肺部局限性 GGO 的影像學診斷方法及外科處理策略. 臨床肺科雜志, 2013, 18(6):1104-1105.
9. 曹曉明, 鄧朝勝, 林其昌, 等. 肺部磨玻璃樣病變的診治進展. 中華結核和呼吸雜志, 2015,38(4): 298-301.
10. Matsuguma H, Mori K, Nakahara R, et al. Characteristics of subsolid pulmonary nodules showing growth during follow-up with CT scanning. Chest, 2013, 143(2): 436-443.
11. Kobayashi Y, Fukui T, Ito S, et al. How long should small lung lesions of ground-glass opacity be followed? J Thorac Oncol, 2013, 8(3): 309-314.
12. Yoshida J, Nagai K, Yokose T, et al. Limited resection trial for pulmonary ground-glass opacity nodules: fifty-case experience. J Thorac Cardiovasc Surg, 2005, 129(5): 991-996.
13. Haneda H, Sasaki H, Lindeman N, et al. A correlation between EGFR gene mutation status and bronchioloalveolar carcinoma features in japanese patients with adenocarcinoma. Jpn J Clin Oncol, 2006, 6(3): 69-75．.
14. Stabile LP, Lyker JS, Gubish CT, et al. Combined targeting of the estrogen receptor and the epidermal growth factor receptor in non-small cell lung cancer shows enhanced antiproliferative eff ects. Cancer Res, 2005, 65(4): 1459-1470.
15. Chung JH, Choe G, Jheon S, et al. Epidermal growth factor receptor mutation and pathologic-radiologic correlation between multiple lung nodules with ground-glass opacity differentiates multicentric origin from intrapulmonary spread. J Thorac Oncol, 2009, 4(12): 1490-1495.
16. 喬文亮, 林強. 肺內磨玻璃影的分子生物學研究進展. 中國肺癌雜志, 2014, 24(3): 235-240.
17. Yoshida J. Management of the peripheral small ground-glass opacities. Thorac Surg Clin, 2007, 17(2): 191-201.
18. 毛海霞, 韓砆石, 項文靜, 等. 肺腺癌局灶性磨玻璃影的診斷與處理. 中華結核和呼吸雜志, 2015, 38(7): 535-537.
19. Song YS, Park CM, Park SJ, et al. Volume and mass doubling times of persistent pulmonary subsolid nodules detected in patients without known malignancy. Radiology, 2014, 273(1): 276-284.
20. Hasegawa M, Sone S, Takashima S, et al. Growth rate of small lung cancers detected on mass CT Screening. Br J Radiol, 2000, 73(876): 1252-1259.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Relationship between the epidermal growth factor receptor gene mutation and malignant pulmonary focal ground-glass lesion

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