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Clinical And Imageological Features Of Lung Squamous Cell Carcinoma With EGFR Mutations

Authors Gao X, Zhu J, Chen L, Jiang Y, Zhou X, Shuai J, Zhao Y

Received 12 July 2019

Accepted for publication 18 September 2019

Published 21 October 2019 Volume 2019:11 Pages 9017—9024


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Lu-Zhe Sun

Xuejuan Gao,1,* Junjie Zhu,2,* Linsong Chen,2,* Yan Jiang,2 Xiao Zhou,2 Jianwei Shuai,1,3 Yanfeng Zhao2

1Department of Physics, Xiamen University, Xiamen, People’s Republic of China; 2Department of Thoracic Surgery, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, People’s Republic of China; 3State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, Xiamen University, Xiamen, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jianwei Shuai
Department of Physics, Xiamen University, Xiamen 361005, People’s Republic of China
Tel +86 139 5928 7814
Yanfeng Zhao
Department of Thoracic Surgery, Shanghai Pulmonary Hospital affiliated to Tongji University, Shanghai 200433, People’s Republic of China
Tel +86 130 1281 4641

Purpose: To analyze the distribution of epidermal growth factor receptor (EGFR) mutations; characterize the clinical and imageological features of lung squamous cell carcinoma (LSCC) in a large population of patients; and assess correlations between clinical and imageological characteristics and clinical outcomes of LSCC patients harboring EGFR mutations.
Patients and methods: Three pathologists retrospectively evaluated the morphological and immunohistochemical data of 2,322 patients with LSCC resected between February 2013 and December 2017. Data on the distribution of EGFR mutations and the clinical and imageological characteristics of the patients were retrospectively collected. Correlations between the EGFR mutation status and clinical outcomes were evaluated using univariate and multivariate analyses.
Results: EGFR mutations were found in 3.4% of patients with LSCC and predominantly in female and non-smoking patients. Tumor lesions in patients with EGFR-positive mutations were more irregularly shaped than those in patients with EGFR-negative mutations (P = 0.045). In non-smoking patients with LSCC, the proportion of marked spiculation was significantly higher in the EGFR-positive group than in the EGFR-negative group (P = 0.043). No significant difference in recurrence-free survival was noted between LSCC patients harboring EGFR-positive and those harboring EGFR-negative mutations. No difference in metastases was observed between the EGFR-positive and EGFR-negative cohorts.
Conclusion: Female gender, non-smoking habit, irregularly shaped tumor, and marked spiculation might predict the presence of EGFR mutations in LSCC. The administration of tyrosine kinase inhibitors to patients with LSCC after screening for EGFR mutations based on their clinical and imageological features would likely result in a population with a greater sensitivity to afatinib.

Keywords: EGFR mutation, lung squamous cell carcinoma, imageological feature, recurrence-free survival

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