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Background  The study was conducted to evaluate the clinical and computed tomography (CT) findings of non‐small cell lung cancer (NSCLC) patients to distinguish between  ALK  gene rearrangement,  EGFR  mutation, and non‐ ALK / EGFR  (no genetic abnormalities).    Methods  We enrolled 201 patients with primary NSCLC who had undergone molecular testing for both  ALK  gene rearrangement and  EGFR  mutation. The clinical features and CT findings of the main lesion and associated pulmonary abnormalities were investigated.    Results  Female gender ( P  = 0.0043 vs. non‐ ALK / EGFR ), young age ( P  = 0.0156 vs.  EGFR ), and a light or never smoking history ( P  = 0.0039 vs. non‐ ALK / EGFR ) were significant clinical characteristics of NSCLC with  ALK  gene rearrangement. The significant CT characteristics compared to NSCLC with  EGFR  mutation were a large mass ( P  = 0.0155), solid mass ( P  = 0.0048), and no air bronchogram ( P  = 0.0148). A central location ( P  = 0.0322) and lymphadenopathy ( P  = 0.0353) were also more frequently observed. Coexisting emphysema was significantly less frequent in NSCLC patients with  ALK  gene rearrangement ( P  = 0.0135) than non‐ ALK / EGFR .    Conclusions  NSCLC with  ALK  gene rearrangement was more likely to develop in younger women with a light or never smoking history. The characteristic CT findings of NSCLC with  ALK  gene rearrangement were a large solid mass, less air bronchogram, a central location, and lymphadenopathy.

thoracic cancer

Clinical and computed tomography characteristics of non‐small cell lung cancer with ALK gene rearrangement: Comparison with EGFR mutation and ALK/EGFR‐negative lung cancer