胸腺上皮肿瘤Masaoka分期的术前CT预测  

Preoperative CT prediction for Masaoka staging of thymic epithelial tumor

作　　者：冯湛[1] 黄朕[2] 张亮[3] 

机构地区：[1]浙江大学医学院附属第一医院放射科,杭州310003 [2]浙江省新华医院放射科 [3]浙江省肿瘤医院放射科

出　　处：《中华放射学杂志》2013年第3期216-219,共4页Chinese Journal of Radiology

摘　　要：目的探讨术前CT预测胸腺上皮肿瘤（TET）Masaoka分期的价值。方法回顾性分析102例经手术病理证实的TET的CT表现，并根据Masaoka分期分组，将肿瘤大小、密度、边缘、形态、周围侵犯情况、转移等CT表现进行Logistic回归分析，再用ROC曲线评价CT诊断效能。结果102例TET分期为Ⅰ期36例（35．3％），Ⅱ期27例（26．5％），Ⅲ期30例（29．4％），Ⅳ期9例（8．8％）。多因素Logistic回归研究发现肿瘤体积较大（20／35，P=0．0371，OR=4．539）、密度不均（26／42，P=0．0230，OR=4．870）、边缘分叶或不规则（21／33，P=0．0154，OR=6．020）、纵隔脂肪层消失（25／32，P=0．0019，OR=14．005）及胸膜种植（11／11，P=0．0032，OR=36．153）与Ⅲ、Ⅳ期肿瘤相关，ROC曲线下面积为0．940。结论CT能将TETⅢ、Ⅳ期和Ⅰ、Ⅱ期区分出来，使部分TET患者从新辅助放化疗治疗中受益。Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors（TET） before surgical resection. Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively. The TET were reclassified according to Masaoka stage system. The size, homogeneity, sharp, contour, infiltration of surrounding tissue, and metastasis on CT were analyzed with Logistic analysis. The diagnostic value was also evaluated with a ROC curve. Results Masaoka pathologic stages were stage Ⅰ for 36 （ 35.3 % ）, stageⅡfor 27 （26. 5 % ）, stage Ⅲ for 30 （29.4 % ）, and stage Ⅳ for 9 （ 8. 8 % ）. A multivariable Logistic regression model showed that TET with larger size of tumor （20/35, P = 0. 0371, OR = 4. 539 ）, irregular or lobulated tumor contour （26/42, P = 0. 0230, OR = 4. 870 ）, heterogeneous （ 21/33, P = 0. 0154, OR = 6. 020 ）, infiltration of surrounding fat （25/32, P = 0. 0019, OR = 14. 005 ） , and pleural seeding （ 11/11, P = 0. 0032, OR = 36. 153 ）were more likely to have stage Ⅲ or Ⅳ disease. The area under ROC curve was 0. 940. Conclusions The tumor CT imaging features can differentiate between stage Ⅰ, Ⅱand stage Ⅲ, Ⅳ disease. This helps identified patients more likely to benefit from neoadjuvant therapy.

关 键 词：胸腺瘤 肿瘤分期 肿瘤辅助治疗 体层摄影术 X线计算机 

分 类 号：R736.3[医药卫生—肿瘤]