Clinical and radiological features associated with EGFR mutation in non-small-cell lung cancer: a study of 149 cases

Abstract

Abstract Background Lung cancer is the leading cause of cancer death in the world. Non-small-cell lung cancer (NSCLC) accounts for 85% of primary lung tumors. Epidermal growth factor receptors (EGFRs) are found on the surface of tumor cells, and their role is to send a growth signal to the cell nucleus. Tumor cells with EGFR mutations are very sensitive to cancer treatments called "Targeted Therapies." The search for EGFR mutations requires lung biopsies. Some studies have shown a correlation between clinico-radiological characteristics and the EGFR mutation. In this study, an attempt was made to identify the relevant clinico-radiological characteristics associated with the EGFR mutation in patients with NSCLC. Objectives The main objective of this study was to evaluate the clinico-radiological characteristics useful for predicting the risk of EGFR mutation in patients with NSCLC. Materials and methods This is a retrospective cross-sectional study, carried out in 149 patients followed up for lung adenocarcinoma who benefited from an EGFR mutation study at the anatomopathology department of the University Hospital of Fez, spread over a period of 4 years (between January 2018 and December 2021). A database was compiled from this study, including sociodemographic, clinical, anatomopathological and radiological data. A statistical analysis was carried out in order to identify the factors associated with EGFR mutation. Results According to the inclusion and exclusion criteria, of the 149 patients included, the mean age was 61.05 + / − 11.095 years. Males predominated with a percentage of 70.5% (n = 105). Fifty-seven point seven percent of patients were smokers or ex-smokers. Forty-one patients had an EGFR mutation, representing a percentage of 27.5%. Multivariate analysis by logistic regression revealed an association of the EGFR mutation with irregular contours (ORA = 6.43; CI95% 1.26;32.78), with the presence of spiculations (ORA = 5.81; CI95% 1.96;17.22), with pleural attachment (ORA = 3.53; CI95% 1.32;9.42), with heterogeneous enhancement (ORA = 30.679; CI95% 5.149;182.778), with absence of emphysema (ORA = 4.815; CI95% 1.966;17.220) and with presence of distant metastasis (ORA = 4.123; CI95% 1.373;12.383). Conclusions This study provides substantial evidence to support the assertion that irregular contours, the presence of spiculations, pleural attachment, heterogeneous enhancement, the absence of emphysema and the presence of distant metastasis are statistically correlated with EGFR mutations. The model developed within this study, encompassing all relevant clinical and CT characteristics, has demonstrated its effectiveness as a reliable predictor for EGFR mutations (AUC: 0.7659) and consequently as a key determinant of EGFR-TKI treatment response.