WCLC 2025 - Posters & ePosters-P1.04.21 Molecular Profiles of Clinical and Radiological Features in Pre-Invasive Lung Adenocarcinoma

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This study investigates the relationship between molecular profiles, clinical characteristics, and radiological features in pre-invasive lung adenocarcinoma lesions, specifically adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA). Early detection through imaging is crucial for surgical treatment during this curable phase, yet the molecular basis behind imaging features remains underexplored.<br /><br />Researchers analyzed 371 pre-invasive lesion samples using next-generation sequencing (NGS), examining mutational landscapes alongside clinical and radiological data. Radiological features assessed included marginal spiculation, bubble lucency, cystic airspace, pleural retraction/attachment, lobulation, vessel convergence/crossing, and air bronchogram.<br /><br />Key findings showed that RET gene rearrangements (3.23%) were more frequent than ALK rearrangements (2.43%) in these lesions. Patients with EGFR mutations were older (median age 52) compared to those without (48), whereas ERBB2 mutations and gene rearrangements were associated with younger patients (median ages 44 and 40, respectively). MIA lesions exhibited a higher rate of pleural retraction (31% vs. 14% in AIS).<br /><br />Associations between specific mutations and imaging features were identified: ERBB2 mutations correlated with marginal spiculation; gene rearrangements linked strongly to bubble lucency; RET and EGFR exon 19 deletions were enriched in cystic airspace features; EGFR mutations positively correlated with pleural retraction, in contrast to an inverse relationship with KRAS mutations. Additionally, ALK alterations were more common in lesions with pleural attachment, while KRAS again showed an inverse association.<br /><br />This comprehensive analysis of molecular and radiological characteristics in a large cohort of pre-invasive lung adenocarcinoma offers insights into the biological underpinnings of imaging phenotypes. These findings may enhance early diagnosis precision and inform surgical decision-making during this critical, treatable stage.

Asset Subtitle

Yi-Duo Lin

Meta Tag

Speaker Yi-Duo Lin

Topic Screening and Early Detection

Keywords

pre-invasive lung adenocarcinoma

adenocarcinoma in situ (AIS)

minimally invasive adenocarcinoma (MIA)

molecular profiling

next-generation sequencing (NGS)

radiological features

RET gene rearrangements

EGFR mutations

ERBB2 mutations

pleural retraction