Depicting growth characteristics with computed tomography for KRAS-mutated lung adenocarcinoma.

Background: Kirsten rat sarcoma viral oncogene homolog (KRAS) is a key oncogenic driver in lung adenocarcinoma (LUAD). The correlation between KRAS mutations and the computed tomographic (CT) texture features in LUAD patients is not well established. This study aimed to investigate the relationship between the CT texture features of LUAD and the KRAS mutation.

Methods: This study included 808 LUAD patients who were diagnosed with the KRAS mutation and underwent surgical resection at the Huadong Hospital. Of the 808 patients, 720 had preoperative chest CT data, which were collected for retrospective analysis. Further, all the CT images of lesions were classified into different categories based on the CT texture features. Moreover, the association between KRAS status and the clinical features and CT texture features was evaluated.

Results: The results revealed that KRAS mutations were more common in the male patients than the female patients [8.5% (29/341) 2.4% (11/467), P<0.0001] and were more frequent in the older patients than the younger patients [6.5% (29/448) 3.1% (11/360), P=0.02]. The CT texture feature of mixed ground-glass opacity (mGGO) indicated a lower incidence of KRAS mutations than the CT texture features of pure ground-glass opacity (pGGO) [1.3% (3/232) 6.7% (15/225), P=0.0032] and pure solid opacity (pSO) [1.3% (3/232) 6.1% (16/263), P=0.0056]. Moreover, a comparison of the frequency of pGGOs and pSOs ≤1 cm showed that the frequency of PGOs was higher than that of pSOs for KRAS mutations wild type, but the statistical significance was marginal [12.0% (11/92) 0% (0/27), P=0.05].

Conclusions: This study revealed that KRAS mutations were more common in male and older LUAD patients. Further, in most LUAD patients with KRAS mutations, pGGOs changed into pSOs at the size of >1 cm at least.