[Relationship between EGFR, ALK Gene Mutation and Imaging 
and Pathological Features in Invasive Lung Adenocarcinoma]

Area of Science:

• Oncology
• Radiology
• Genetics

Background:

• Targeted therapies for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene mutations offer new hope for advanced lung adenocarcinoma.
• Specific imaging and pathological features of EGFR and ALK mutations in lung adenocarcinoma remain subjects of ongoing research and debate.
• This study investigates the correlation between EGFR, ALK gene mutations, and their associated imaging and pathological characteristics in invasive lung adenocarcinoma.

Purpose of the Study:

• To explore the relationship between EGFR and ALK gene mutations and specific imaging and pathological features in lung adenocarcinoma.
• To identify distinct imaging and clinicopathological characteristics associated with EGFR (exon 19 and 21 subtypes) and ALK gene mutations.
• To provide insights for guiding clinical diagnosis and treatment strategies for pulmonary nodules based on genetic mutation status.

Main Methods:

• Retrospective analysis of 525 lung adenocarcinoma patients who underwent surgery.
• Patients were categorized into EGFR mutation, ALK mutation, and wild-type groups based on postoperative gene detection.
• Univariate and multivariate logistic regression analyses were used to compare pathological features (histological subtype, lymph node metastasis, VPI) and imaging features (tumor diameter, CTR, lobulation, spiculation, pleural retraction, air bronchus, vacuole signs) between groups.

Main Results:

• EGFR mutations were associated with female patients and the pleural traction sign. Exon 21 subtype linked to older age, female sex, larger tumor diameter, and pleural traction sign. Exon 19 subtype associated with female sex, high solid component proportion, and lobulation sign.
• ALK mutations were more frequent in younger patients with a smoking history, and associated with micropapillary components and visceral pleural invasion (VPI).
• EGFR mutations showed limited correlation with lymph node metastasis and VPI.

Conclusions:

• Lung adenocarcinomas with EGFR and ALK gene mutations exhibit specific imaging and clinicopathological features.
• Distinct imaging features differentiate EGFR exon 19 and exon 21 subtypes.
• These findings are significant for guiding the clinical diagnosis and treatment of pulmonary nodules.