Guangliang Qiang¹, Chaoyang Liang¹, Rui Xu², Jue Yan², Yanyan Xu³, Ye Wang⁴, Jiping Da⁴, Bin Shi¹, Yongqing Guo¹, Deruo Liu¹

¹Department of Thoracic Surgery, China-Japan Friendship Hospital, ²Department of Nuclear Medicine, China-Japan Friendship Hospital, ³Department of Radiology, China-Japan Friendship Hospital, ⁴Department of Pathology, China-Japan Friendship Hospital

Objective:The aim of this study is to investigate the correlation of histopathologic subtypes with epidermal growth factor receptor (EGFR) mutations and ¹⁸F-fluorodeoxyglucose (FDG) uptake in lung adenocarcinomas (ADCs). Method: A total of 97 patients with ADC who underwent ¹⁸F-FDG positron emission tomography (PET)/CT scan prior to surgical resection were retrospectively reviewed. All cases were divided according to the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification, and graded by histopathologic scoring system. EGFR mutations were identified as well. Clinicopathological factors associated with EGFR mutation status were evaluated by univariate and multivariate analysis. Result:The frequency of EGFR mutation was 45.4% and associated with gender, smoking, maximum standardized uptake value (SUVmax) and histopathologic score. ADC patients with low SUVmax were more likely to carry EGFR mutations than those with high SUVmax (P=0.018), and patients with lower histopathologic score showed significantly lower SUVmax than those with higher score (P<0.001). Moreover, histopathologic score and smoking history were found to be independent predictors for EGFR mutation according to multivariate logistic regression analysis. Conclusion: SUVmax and EGFR mutations correlate to the stratification of lung ADCs based on the IASLC/ATS/ERS classification. SUVmax promises a useful marker in stratifying preoperative patients with lung ADCs and identifying EGFR mutations in case of unavailable molecular diagnostics.

Key Words: Adenocarcinoma  Histologic subtype  Epidermal growth