CT影像组学模型预测肺腺癌EGFR基因突变的价值与研究进展

Value and Research Progress of CT-Based Radiomics Models in Predicting EGFR Genetic Mutations in Lung Adenocarcinoma

摘要: 肺癌是全球发病率和死亡率的最高恶性肿瘤之一，主要的病理类型是非小细胞肺癌(Non-small cell lung cancer, NSCLC)，约占85%，目前NSCLC中又以肺腺癌最为常见。表皮生长因子受体(Epidermal growth factor receptor, EGFR)与肺腺癌的发生、发展密切相关，约50%肺腺癌患者存在EGFR基因突变。近年来随着靶向治疗和免疫治疗等新型疗法的快速发展，临床上伴随EGFR突变的肺腺癌患者使用表皮生长因子受体酪氨酸激酶抑制剂(Epidermal growth factor receptor tyrosine kinase inhibitors, EGFR-TKIs)进行靶向治疗取得了明显成效，且极大程度提高了晚期肺腺癌患者的存活时间，因此基因检测显得尤为重要。以往基因检测常依赖于穿刺活检，近年来随着影像组学的不断发展，基于肺腺癌的影像学特征建立影像组学模型无创性地预测患者EGFR突变状态取得了较为满意的成果。本文就近5年影像组学模型预测肺腺癌EGFR基因突变的研究进展进行综述。

Abstract: Lung cancer is one of the malignant tumors with the highest morbidity and mortality worldwide, and its major pathological type is non-small cell lung cancer (NSCLC), which accounts for approximately 85%. Currently, lung adenocarcinoma is the most common subtype of NSCLC. The epidermal growth factor receptor (EGFR) is closely associated with the occurrence and progression of lung adenocarcinoma, and approximately 50% of patients with lung adenocarcinoma harbor EGFR gene mutations. In recent years, with the rapid development of novel therapies such as targeted therapy and immunotherapy, clinically, patients with lung adenocarcinoma harboring EGFR mutations have achieved significant therapeutic outcomes with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), and survival time has been substantially prolonged for patients with advanced lung adenocarcinoma. Therefore, gene testing is particularly important. Historically, genetic testing predominantly relied on core needle biopsy. In recent years, with the continuous advancement of radiomics, satisfactory results have been achieved in developing radiomics models based on imaging features of lung adenocarcinoma to noninvasively predict the EGFR mutation status of patients. This article reviews the research progress of radiomics models for predicting EGFR mutations in lung adenocarcinoma over the past five years.