Clinical and CT patterns to predict EGFR mutation in patients with non-small cell lung cancer: A systematic literature review and meta-analysis

Ortiz, Andrés Felipe Herrera; Camacho, Tatiana Cadavid; Vásquez, Andrés; Herazo, Valeria del Castillo; Neira, Juan Guillermo Arámbula; Yepes, María Mónica; Camacho, Eduard Cadavid

doi:10.1016/j.ejro.2022.100400

Cited by 8 publications

(6 citation statements)

References 55 publications

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“…Many studies have been conducted to predict the EGFR mutation status of lung cancer based on imaging, stipulating that the EGFR mutation is associated with females and non-smokers. Radiological features associated with EGFR mutation are ground-glass attenuation of the tumor, the presence of air bronchogram, vascular convergence, spiculated margin, and pleural retraction [16] . On the other hand, wild-type EGFR tend to be linked to male and smoking [17] and is less likely to cause diffuse metastatic process [18] .…”

Section: Discussionmentioning

confidence: 99%

Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study

Shalahuddin

Hayati

2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study

Shalahuddin

Hayati

2023

Radiology Case Reports

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“…In this study, the EGFR mutation rate of lung adenocarcinoma patients was 60.8%, and the mutant group was more likely to have imaging signs such as bronchial sign, pleural indentation sign, and vessel convergence sign. A meta‐analysis 27 also pointed out that some CT imaging features were risk factors for EGFR mutation in NSCLC patients. In clinical practice, the detection rate of EGFR mutation is much lower than expected due to the lack of tumor specimens, poor quality of specimens, and economic reasons 13,28 .…”

Section: Discussionmentioning

confidence: 99%

Association between squamous cell carcinoma antigen level and EGFR mutation status in Chinese lung adenocarcinoma patients

Zhang

Gao

Niu

et al. 2022

Clinical Laboratory Analysis

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Background To investigate the association between squamous cell carcinoma antigen (SCCAg) level and epidermal growth factor receptor ( EGFR ) mutation status in Chinese lung adenocarcinoma patients. Methods We retrospectively analyzed 293 patients with lung adenocarcinoma, divided into EGFR mutant group ( n = 178) and EGFR wild‐type group ( n = 115). The general data and laboratory parameters of the two groups were compared. We used univariable and multivariable logistic regression to analyze the association between SCCAg level and EGFR mutation. Generalized additive model was used for curve fitting, and a hierarchical binary logistic regression model was used for interaction analysis. Results Squamous cell carcinoma antigen level in the EGFR wild‐type group was significantly higher than that in the mutant group ( p < 0.001). After adjusting for confounding factors, we found that elevated SCCAg was associated with a lower probability of EGFR mutation, with an OR of 0.717 (95% CI: 0.543–0.947, p = 0.019). For the tripartite SCCAg groups, the increasing trend of SCCAg was significantly associated with the decreasing probability of EGFR mutation ( p for trend = 0.015), especially for Tertile 3 versus Tertile 1 (OR = 0.505; 95% CI: 0.258–0.986; p = 0.045). Curve fitting showed that there was an approximate linear negative relationship between continuous SCCAg and EGFR mutation probability ( p = 0.020), which was first flattened and then decreased ( p < 0.001). The association between the two was consistent among different subgroups, suggesting no interaction (all p > 0.05). Conclusion There is a negative association between SCCAg level and EGFR mutation probability in Chinese lung adenocarcinoma patients.

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“…Detecting these two oncogenic driver mutations has become essential in the treatment of NSCLC, specifically adenocarcinoma [ 6 ], as both mutations are sensitive to drugs that target EGFR [ 2 ], and screening for these mutations predict which patients will respond to therapy [ 7 ]. Advances in research demonstrated that EGFR mutations are linked to specific risk factors such as the absence of smoking and female sex, and radiological imaging features such as ground-glass opacities (GGO), air bronchogram, vascular convergence, pleural retraction, spiculation [ 5 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Radiological Characteristics to Differentiate Between EGFR Exon 21 and Exon 19 Mutations in Patients With Lung Adenocarcinoma: A Systematic Literature Review and Meta-Analysis

Ortiz¹,

Garland²,

Almarie³

2022

Cureus

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Epidermal Growth Factor Receptor (EGFR) mutations in lung adenocarcinoma have been previously associated with specific clinical characteristics and Computed Tomography (CT) patterns. However, associations among individual EGFR mutations have not been evaluated. We aim to differentiate if the most common EGFR mutations (exon 21 and 19) are related to specific clinical characteristics or CT patterns. A systematic review and meta-analysis of 5 databases were conducted with literature from January 2002 to July 2021. Eligible studies were of an experimental or observational design that included lung adenocarcinoma patients with confirmed EGFR exon mutations (21 and 19) and associated clinical characteristics and CT imaging patterns. Quality was assessed using the QUADAS-2 tool. The association between clinical and CT patterns and EGFR exon mutations 21 and 19 was evaluated using odds ratios (OR) and then pooled and analyzed with a fixed or random-effects model. This study follows the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. A total of 12 retrospective diagnostic accuracy studies were included. Pooled analysis showed that characteristics such as absence of smoking status (OR 1.29 [95% CI 0.97 - 1.70]), and female sex (OR 1.23 [95% CI 0.83 - 1.82]); and CT patterns such as Ground Glass Opacities (GGO) (OR 1.03 [95% CI 0.78 -1.34]), air bronchogram (OR 0.78 [95% CI 0.44 -1.39]), pleural retraction (OR 0.83 [95% CI 0.53 - 1.28]), and spiculation (OR 0.80 [95% CI 0.48 - 1.31]) were not significantly associated to a specific mutation. Specific EGFR exon 21 and 19 mutations cannot be differentiated through characteristics (absence of smoking status and female sex) or radiological patterns (GGO, air bronchogram, pleural retraction, and speculation). There is limited data to assess if early disease stage or vascular convergence aids in differentiating exon 21 from 19 mutations in patients with lung adenocarcinoma.

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Clinical and CT patterns to predict EGFR mutation in patients with non-small cell lung cancer: A systematic literature review and meta-analysis

Cited by 8 publications

References 55 publications

Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study

Pleural metastasis of pulmonary adenocarcinoma mimicking diffuse mesothelioma: A case report and literature study

Association between squamous cell carcinoma antigen level and EGFR mutation status in Chinese lung adenocarcinoma patients

Clinical and Radiological Characteristics to Differentiate Between EGFR Exon 21 and Exon 19 Mutations in Patients With Lung Adenocarcinoma: A Systematic Literature Review and Meta-Analysis

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