Objective To investigate the correlation between epidermal growth factor receptor (EGFR) gene mutation with clinical and high-resolution CT (HRCT) imaging features in patients with stages Ⅰ −ⅢB resectable peripheral non-small cell lung cancer (NSCLC).

Methods A total of 164 patients with peripheral NSCLC who underwent lung cancer resection, EGFR genetic testing, and clinical staging of Ⅰ −ⅢB in Huizhou Central People's Hospital from January 2019 to April 2021 were retrospectively analyzed. The cohort included 86 males and 78 females, aged 60.3±9.3 years. According to the results of EGFR genetic testing, the patients were divided into EGFR mutation and wild-type groups. The clinical and HRCT imaging features of the patients were analyzed and statistically analyzed. The measurement data were compared by two-independent-sample t-test, and the counting data were compared by chi-square and Fisher's exact probability tests. Indicators with statistical differences were selected for binary Logistic regression analysis. The area under curve of the receiver operating characteristic (ROC) curve was used in evaluating the diagnostic efficiency of the regression model.

Results Among the 164 patients with NSCLC, 114 (69.51%) were confirmed to have EGFR mutations, and 50 (30.49%) had wild-type EGFR. Compared with the wild-type EGFR, EGFR mutations were more frequent in non smoking, female patients aged <60 years with a pathological type of adenocarcinoma. Differences between the groups were statistically significant (χ²=21.91, −4.71, 34.64; Fisher's exact probability method, all P<0.05). As observed in HRCT imaging features, the maximum diameter of EGFR mutation group was smaller than that of the wild-type group ((2.52±1.51) cm vs. (4.12±6.07) cm), and the tumors were mostly located in the right lung, with ground-glass opacity or mixed ground-glass opacity, lobulation sign, bronchial inflation sign, and pleural traction sign, compared with the wild-type group, and the differences were statistically significant (t=2.14, χ²=10.13–19.05, all P<0.05). No significant differences in postoperative clinical stage, carcinoembryonic antigen level, lesions with burr signs, necrosis, vascular convergence sign, vacuole sign, cavity sign and thoracic lymphadenopathy were found between the groups (χ²=0.40–2.33, Fisher's exact probability method, all P>0.05). The results of Logistic regression analysis showed that patients with no smoking history (OR=0.225, 95%CI: 0.066–0.764) and tumor accompanied by lobulation sign (OR=3.344, 95%CI: 1.079–10.360) are the independent predictors of EGFR gene mutation (all P<0.05), and the area under the curve of the regression model was 0.858.

Conclusion The clinical and imaging features of resectable peripheral NSCLC in stages Ⅰ −ⅢB are correlated with EGFR gene mutation, which are of great significance to assess the patient's condition.