Correlation of 18F-FDG PET/CT Signs and Ki-67 Expression with EGFR Mutation in Lung Adenocarcinoma
Objective To explore the correlation of 18F-FDG PET/CT signs and Ki-67 expression with epidermal growth factor receptor(EGFR)mutation in lung adenocarcinoma.Methods We retrospectively analyzed the 18F-FDG PET/CT data,immunohistochemical,the expression of Ki-67 and general clinical data of 95 patients with pathologically confirmed lung adenocarcinoma.To analyze the differences of PET/CT manifestations,the expression of Ki-67,gender,age,smoking status for EGFR mutation status.Receiver operating characteristic(ROC)curve was used to test the cult-off of maxium standard uptake(SUVmax).Logistic regression model was employed to analyze the independent predictive factors for EGFR.Results Patients with EGFR mutations had significantly lower SUVmax than wild-type EGFR patients(t=2.813,P=0.006).Further analysis found that patients with type Exon 21 of EGFR mutation had lower SUVmax than wild-type patients(t=3.274,P=0.002),but there was no statistical difference in SUVmax between type Exon 19 of EGFR mutation and wild type patients(t=1.323,P=0.193),There was no statistically significant difference between the two different types of mutant SUVmax(t=-1.579,P=0.124).ROC curve showed that the cut-off of SUVmax was 6.36.The low expression rate of Ki-67 was more common in EGFR mutant patients than in wild-type patients(x2=4.867,P=0.027),There was a statistically significant difference in the expression of Ki-67 between the exon 21 mutant and the wild type(x2=5.576,P=0.018);there was no significant difference in the expression of Ki-67 between the exon 19 mutant and wild type(x2=0.328,P=0.567).the expression of two different types of mutant Ki-67 was not statistically significant(x2=1.791,P=0.181).Univariate analysis showed that gender,smoking,lobulation sign,vessel convergence sign and SUVmax were all associated with EGFR mutation(P＜0.05),age,spiculation sign,pleural indentation sign,vacuole sign,and bronchial truncation sign are not related to EGFR mutation(P＞0.05).Logistic multivariate analysis showed that smoking status and SUVmax were the independent factors for predicting EFGR(P＜0.05).Conclusion SUVmax of 18F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with unresectable lung adeocarcinoma,and it has certainly reference value for predicting EGFR mutation.
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