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. 2016 Jul;17(4):271-8.
doi: 10.1016/j.cllc.2015.11.002. Epub 2015 Nov 12.

Association Between Computed Tomographic Features and Kirsten Rat Sarcoma Viral Oncogene Mutations in Patients With Stage I Lung Adenocarcinoma and Their Prognostic Value

Hua Wang  1 , Matthew B Schabath  2 , Ying Liu  1 , Olya Stringfield  3 , Yoganand Balagurunathan  3 , John J Heine  3 , Steven A Eschrich  4 , Zhaoxiang Ye  5 , Robert J Gillies  6
Affiliations

Association Between Computed Tomographic Features and Kirsten Rat Sarcoma Viral Oncogene Mutations in Patients With Stage I Lung Adenocarcinoma and Their Prognostic Value

Hua Wang et al. Clin Lung Cancer. 2016 Jul.

Abstract

Background: We investigated the association between computed tomographic (CT) features and Kirsten rat sarcoma viral oncogene (KRAS) mutations in patients with stage I lung adenocarcinoma and their prognostic value.

Patients and methods: A total of 79 patients with pathologic stage I lung adenocarcinoma, available KRAS mutational status, preoperative CT images available, and survival data were included in the present study. Seven CT features, including spiculation, concavity, ground-glass opacity, bubble-like lucency, air bronchogram, pleural retraction, and pleural attachment, were evaluated. The association among the clinical characteristics, CT features, and mutational status was analyzed using Student's t test, the χ(2) test or Fisher's exact test, and logistic regression. The association among CT features, mutational status, and overall survival was analyzed using Kaplan-Meier survival curves with the log-rank test and Cox proportional hazard regression.

Results: The prevalence of KRAS mutations was 41.77%. Spiculation was significantly associated with the presence of KRAS mutations (odds ratio, 2.99; 95% confidence interval [CI], 1.16-7.68). Although KRAS mutational status was not significantly associated with overall survival, the presence of pleural attachment was associated with an increased risk of death (hazard ratio, 2.46; 95% CI, 1.09-5.53). When analyzing KRAS mutational status and pleural attachment combined, patients with wild-type KRAS and no pleural attachment had significantly better survival than did those with wild-type KRAS and pleural attachment (P = .014).

Conclusion: These data suggest that spiculation is associated with KRAS mutations and pleural attachment is associated with overall survival in patients with stage I lung adenocarcinoma. Combining the analysis of KRAS mutational status and CT features could better predict survival.

Keywords: Computed tomography; Imaging; KRAS; Lung neoplasms; Prognosis.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curve for pleural attachment.
Figure 2
Figure 2
Kaplan–Meier survival curve for combined analysis of KRAS mutational status and pleural attachment (PA).
See this image and copyright information in PMC

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