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Updated: Sep 6, 2025
Detection of Alternative Splicing During Epithelial-Mesenchymal Transition
Published on: October 9, 2014
Characteristic computed tomography features in mesenchymal-epithelial transition exon14 skipping-positive non-small
Naokazu Watari1,2, Kakuhiro Yamaguchi3, Hiroaki Terada4
1Department of Respiratory Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Background:
Mesenchymal-epithelial transition exon14 (METex14) skipping is one of the therapeutic driver oncogene mutations in non-small cell lung cancer (NSCLC), and can be treated with tepotinib and capmatinib. There is only one report on computed tomography (CT) findings of METex14 skipping-positive NSCLC, which shows that the primary tumor tends to have a large mass in the upper lobe, and extrathoracic metastases are common. This study examined the CT findings of METex14 skipping-positive NSCLC, focusing on the features of the margins and internal structures.
Methods:
We consecutively included patients with METex14 skipping-positive NSCLC who were diagnosed between January 2018 and December 2020 at four independent institutions. We retrospectively reviewed the patient demographics and CT findings for tumor margins (invasion into surrounding tissue, lobulation, pleural indentation, spicula, and ground-glass opacity) and internal structures (air bronchograms, cavitation and internal low-density area).
Results:
Fifteen patients with METex14 skipping-positive NSCLC were identified. Almost half of the patients were men (7/15; 46.7%), and their median age was 75.0 years. More than half were either current or former smokers (9/15; 60.0%). A vast majority of histological subtypes were adenocarcinoma (10/15; 66.7%), followed by pleomorphic carcinoma (3/15; 20.0%) and squamous cell carcinoma (2/15; 13.3%). With regard to CT findings, most primary tumors presented as masses larger than 30 mm (12/15; 80.0%) and were located in the upper lobes (12/15; 80.0%). Invasion into surrounding tissue and presence of internal low-density areas were observed in 60.0% (9/15) and 66.7% (10/15) of the primary tumors, respectively. Additionally, their frequencies increased to 72.7% (8/11) and 90.9% (10/11) in stage III/IV cases, respectively. In lymph node metastasis, internal low-density areas were observed in 8/10 cases (80.0%). Although these two CT features were rarely observed in distant metastases at diagnosis, they became apparent with progression of the metastatic tumor size.
Conclusions:
METex14 skipping-positive NSCLC tumors tend to invade surrounding tissue and possess internal low-density areas. These CT findings might be characteristic of METex14 skipping-positive NSCLC.
Insights
Mesenchymal-epithelial transition exon14 skipping non-small cell lung cancer (METex14 NSCLC) tumors often invade surrounding tissue and show internal low-density areas on CT scans. These imaging features may help identify this specific NSCLC subtype.
Area of Science:
- Oncology
- Radiology
- Genetics
Background:
- Mesenchymal-epithelial transition exon14 (METex14) skipping is a key oncogenic driver in non-small cell lung cancer (NSCLC).
- Targeted therapies like tepotinib and capmatinib are available for METex14-altered NSCLC.
- Limited data exists on the computed tomography (CT) imaging characteristics of METex14-skipping NSCLC.
Purpose of the Study:
- To investigate and characterize the CT findings of primary tumors in METex14-skipping NSCLC.
- To identify specific CT features related to tumor margins and internal structures.
- To correlate CT findings with clinical and pathological characteristics.
Main Methods:
- Retrospective review of CT scans from 15 patients with METex14-skipping NSCLC diagnosed between 2018-2020.
- Analysis of tumor margins including invasion, lobulation, pleural indentation, spicula, and ground-glass opacity.
- Evaluation of internal structures such as air bronchograms, cavitation, and internal low-density areas.
Main Results:
- Primary tumors were predominantly large (>30 mm) and located in upper lobes (80%).
- Invasion into surrounding tissue (60%) and internal low-density areas (66.7%) were common in primary tumors.
- Internal low-density areas were also frequent in lymph node metastases (80%) and became more apparent with tumor progression.
Conclusions:
- METex14-skipping NSCLC tumors frequently exhibit invasion into surrounding tissue.
- The presence of internal low-density areas on CT scans is a notable characteristic.
- These CT findings may serve as potential imaging biomarkers for identifying METex14-skipping NSCLC.
