【摘要】 目的 探讨周围型肺腺癌表皮生长因子受体(EGFR)基因突变与其CT上磨玻璃影(GGO)成分含量、病理表现的相关性。方法 回顾性分析245例经术后病理证实的周围型肺腺癌的影像及临床资料。运用扩增阻滞突变系统(ARMS)检测腺癌组织的EGFR基因突变情况；依据2015年WHO公布的肺腺癌新分类划分组织学类型；利用西门子Somatom Definition Flash CT后处理工作站测量肿瘤GGO成分的体积比并等分为4型。结果 浸润性黏液腺癌EGFR基因突变率(0%)显著低于非浸润性黏液腺癌(79.2%),P<0.05;以贴壁生长为主型腺癌外显子21突变率(65.8%)显著高于非贴壁生长为主型腺癌(37.3%),P<0.05。Ⅳ型外显子21突变率(57.7%)显著高于Ⅰ型(29.6%),P<0.008 3;Ⅱ型的外显子19突变率(40.9%)高于Ⅳ型(15.3%),P<0.008 3。外显子21、19突变率均与肿瘤CT上GGO体积比存在一定趋势关系，P<0.01。结论 在含有GGO成分的周围型肺腺癌中，GGO成分含量及病理分型对于预测EGFR基因突变状态具有一定价值。更多还原

【Abstract】 Objective To investigate the relationship of epidermal growth factor receptor(EGFR) mutation in peripheral lung adenocarcinoma with quantitative CT of ground-glass opacity(GGO) and pathological features.Methods CT and clinical data of 245 patients with peripheral lung adenocarcinoma confirmed by postoperative pathology were analyzed retrospectively.Amplification refractory mutation system(ARMS) was applied to detect the mutation of EGFR gene.Histological subtypes were classified according to 2015 WHO classification of lung adenocarcinoma.The percentage of GGO volume were measured by post-processing workstation on SIEMENS Somatom Definition Flash CT and all lesions were divided into four types averagely.Results The frequency of EGFR mutation in invasive mucinous adenocarcinoma(0%) was lower than other subtypes(79.2%),P<0.05.Exon 21 missense mutation was more frequent in lepidic predominant adenocarcinomas(65.8%) than other subtypes(37.3%),P<0.05.The frequency of exon 21 missense mutation in type Ⅳ(57.7%) was higher than typeⅠ(29.6%),P<0.008 3.The frequency of exon 19 delete mutation in type Ⅱ(40.9%) was higher than type Ⅳ(15.3%),P<0.008 3.A significant trend of prevalence of exon 21 and 19 mutation with GGO volume percentage on CT was found(P<0.01).Conclusion The pathologic characteristics and GGO volume percentage may be useful indicators to predict EGFR mutation in peripheral lung adenocarcinoma.更多还原