Relationship between qualitative and quantitative parameters of three-dimensional computed tomography, EGFR gene mutation, and ALK gene rearrangement in GGO-associated lung adenocarcinoma and their prognostic value.

Abstract

Objective: We aimed to analyze the relationship between the quantitative and qualitative parameters of three-dimensional computed tomography (CT), epidermal growth factor receptor (EGFR), and anaplastic lymphoma kinase (ALK) in ground-glass opacity (GGO)-associated lung adenocarcinoma and determine their prognostic value.

Methods: In total, 208 patients with GGO-associated lung adenocarcinoma admitted to our hospital from January 2019 to September 2021 were selected as study subjects. All participants underwent EGFR gene mutation and ALK gene rearrangement tests. The quantitative and qualitative parameters of three-dimensional CT scans were compared among patients with different EGFR gene mutations and ALK gene rearrangements. Multivariate analysis was conducted to investigate the association of these parameters with EGFR gene mutation and ALK gene rearrangement in patients with GGO-associated lung adenocarcinoma. Furthermore, the quantitative and qualitative parameters of three-dimensional CT scans were compared among patients with different prognoses, and the value of these parameters in predicting patients' prognoses was analyzed.

Results: There were significant differences between patients with wild-type EGFR and patients with mutant EGFR in terms of the bronchial sign (BS), pleural indentation sign (PIS), vascular bundle sign (VBS), maximum nodule diameter (MND), nodule volume (NV), average CT value (ACTV), and solid compartment proportion (SCP) (P < 0.05). There were significant differences between patients with and without ALK gene rearrangement in terms of the BS, PIS, VBS, ACTV, and SCP (P < 0.05). There was a significant difference in BS, PIS, VBS, MND, NV, ACTV, and solidity between patients with favorable prognosis and those with poor prognosis (P < 0.05). The AUC of the combination of BS, PIS, VBS, MND, NV, ACTV, and SCP for predicting patients' prognosis was the highest, significantly higher than the AUC value of individual parameters (P < 0.05).

Conclusion: The quantitative and qualitative parameters of three-dimensional CT are closely associated with EGFR gene mutations, ALK gene rearrangements, and prognosis in patients with GGO-associated lung adenocarcinoma. Moreover, each parameter holds a high value in predicting the prognosis of patients with GGO-associated lung adenocarcinoma.