HUBUNGAN GAMBARAN MULTIDETECTOR COMPUTED TOMOGRAPHY (MDCT) SCAN THORAX METASTASIS KE PLEURA DENGAN STATUS MUTASI EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) PADA PASIEN NON-SMALL CELL LUNG CANCER (NSCLC) DI RUMAH SAKIT DR. WAHIDIN SUDIROHUSODO MAKASSAR = ASSOCIATION BETWEEN THORACIC MDCT FINDINGS OF PLEURAL METASTASES AND EGFR MUTATION IN NON-SMALL CELL LUNG CANCER AT DR. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR

Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. Half of lung cancer patients will experience some metastases at the time of diagnosis. Lung cancer accounts for up to 40% of pleural metastases, followed by breast cancer, which is commonly associated with pleural effusion, accounting for nearly 20% of pleural metastases. MDCT Thorax Scan is important in characterising lung tumours and patterns of intrathoracic extrapulmonary metastasis, which are often found concurrently. The development of lung cancer therapy in the form of targeted therapy is currently the treatment of choice according to the epidermal growth factor receptor (EGFR) mutation status of lung cancer patients. Many studies have been conducted to predict EGFR mutation status in lung cancer based on imaging, but EGFR mutation status and lung tumour metastases behaviour are still relatively limited. This study aims to evaluate the association between pleural metastasis characteristics on MDCT Thorax Scan and EGFR status in NSCLC patients. Methodology: A total of 82 patients with histologically confirmed NSCLC and evidence of pleural metastasis on MDCT were retrospectively analysed. Demographic data, smoking history, histopathological type, and EGFR mutation status were recorded. Pleural manifestations including effusion, thickening, and nodularity were evaluated on MDCT scans. Statistical analysis was performed to determine the relationship between imaging findings and EGFR mutation status. Results : The study population was predominantly male (57.3%) with the highest incidence in the 46– 55 age group (36.6%), and 56.1% were smokers. Adenocarcinoma was the most common histological subtype (63.5%). Pleural effusion was the most common manifestation of pleural metastasis, found in 72 cases (87.8%), and was significantly associated with wild-type EGFR status (p = 0.006). Pleural thickening (18 cases, 22.0%) and pleural nodules (13 cases, 15.8%) did not show a significant association with EGFR mutation. Additionally, no correlation was found between the location or attenuation value of effusion and EGFR status. Conclusion: Pleural effusion is the dominant MDCT finding in NSCLC patients with pleural metastasis and is significantly associated with EGFR wild-type tumours. Pleural thickening and nodularity do not show predictive value for EGFR mutation status. These results suggest that pleural effusion may serve as a radiological marker of advanced wild-type/non-mutation NSCLC progression.