STUDY VALUE OF 18FDG PET/CT IN PREDICTING OF EGFR GENE MUTATION STATUS IN PATENTS WITH LUNG ADENOCARCINOMA

Bùi Tiến Công1,2,, Phạm Văn Thái1,2, Phạm Cẩm Phương1,2, Đồng Thị Hằng3, Phạm Văn Tuyến4, Hoàng Anh Tuấn4, Đoàn Minh Khuy4
1 Hanoi Medical University
2 Nuclear Medicine and Oncology Center, Bach Mai Hospital
3 Bach Mai Hospital
4 Pathology and Cytology Center, Bach Mai Hospital

Main Article Content

Abstract

Research objective: To study the value of FDG PET/CT in predicting EGFR mutation status in patients with lung adenocarcinoma. Subjects and research method: 114 patients with lung adenocarcinoma stage IIIb and IV had FDG PET/CT scan and EGFR mutation test before treatment from November 2018 to July 2020. Results: Mean age of the patients was 62.3±8.4, male (63.2%) female (36.8%), stage IIIb (43.0%) and stage IV (57.0%) ). 43.0% of the study patients did not express PD L1, 57.0% of the study patients had a positive PD L1 test result, from weak to strong level. EGFR mutation rate and mutation-free rate were 55.3% and 44.7%, respectively. The maxSUV value at primary lung tumor in the EGFR positive group (11.2 ± 5.7) was significantly lower than that of the negative EGFR group (15.8 ± 6.2) (p=0, 04). Using the ROC chart, the area under the curve (AUC) of maxSUV in diagnosing positive EGFR  was 0.654 (p<0.05). Combining 4 factors including maxSUV, gender, and smoking status gives better positive EGFR diagnosis results, specifically, the area under the curve (AUC) of the 4 factors is 0.706 (p). <0.05). Conclusion: FDG PET/CT characteristics are relevant and valuable in predicting EGFR mutation status in lung adenocarcinoma patients.

Article Details

References

1. World Health Organization. Globocan (2018): Estimated cancer incidence, mortality and prevalence worldwide in 2018, , xem 9/11/2018.
2. Putora PM, Fruh M, Muller J. FDG-PET SUV-max values do not correlate with epidermal growth factor receptor mutation status in lung adenocarcinoma. Respirology. 2013;18(4):734–735. doi:10.1111/resp.12083
3. Lee SM, Bae SK, Jung SJ, Kim CK. FDG uptake in non-small cell lung cancer is not an independent predictor of EGFR or KRAS mutation status: a retrospective analysis of 206 patients. Clin Nucl Med. 2015;40(12):950–958.
4. Na II, Byun BH, Kim KM, et al. 18F-FDG uptake and EGFR mutations in patients with non-small cell lung cancer: a single-institution retrospective analysis. Lung Cancer. 2010;67(1):76–80.
5. Guan J, Xiao NJ, Chen M, et al. 18F-FDG uptake for prediction EGFR mutation status in non-small cell lung cancer. Medicine. 2016;95(30):e4421.
6. Cho A, Hur J, Moon YW, et al. Correlation between EGFR gene mutation, cytologic tumor markers, 18F-FDG uptake in non-small cell lung cancer. BMC Cancer. 2016;16:224.
7. Takamochi K, Mogushi K, Kawaji H, et al. Correlation of EGFR or KRAS mutation status with 18F-FDG uptake on PET-CT scan in lung adenocarcinoma. PLoS One. 2017;12(4):e0175622.
8. Lv Z, Fan J, Xu J, et al. Value of (18)F-FDG PET/CT for predicting EGFR mutations and positive ALK expression in patients with non-small cell lung cancer: a retrospective analysis of 849 Chinese patients. Eur J Nucl Med Mol I. 2018;45(5):735–750. doi:10.1007/s00259-017-3885
9. Ko KH, Hsu HH, Huang TW, et al. Value of (1)(8)F-FDG uptake on PET/CT and CEA level to predict epidermal growth factor receptor mutations in pulmonary adenocarcinoma. Eur J Nucl Med Mol I. 2014;41(10):1889–1897. doi:10.1007/s00259-014-2802
10. Kanmaz ZD, Aras G, Tuncay E, et al. Contribution of (1)(8) Fluorodeoxyglucose positron emission tomography uptake and TTF-1 expression in the evaluation of the EGFR mutation in patients with lung adenocarcinoma. Cancer Biomark. 2016;16(3):489–498. doi:10.3233/CBM-160588