胸腺瘤239例预后相关因素分析  

Analysis of factors associated with prognosis of 239 case thymoma

作　　者：杨立[1] 范翔宇[1] 陆冬玲[1] 吴俊伟[1] 茅乃权[1] YANG Li FAN Xiang-yu LU Dong-ling WU Jun-wei MAO Nai-quan(Department of Thoracic Oncology , Cancer Hospital of Guangxi Medical University, Nanning 530021 ,P. R. China)

机构地区：[1]广西医科大学附属肿瘤医院胸瘤科,广西南宁530021

出　　处：《中华肿瘤防治杂志》2016年第18期1264-1267,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的 胸腺瘤是最常见的纵隔肿瘤之一,占纵隔肿瘤的20%~40%。本研究探讨影响胸腺瘤预后的相关因素。方法 对广西医科大学附属肿瘤医院1985-10-01-2012-11-30收治的经病理确诊的378例胸腺瘤患者临床资料进行回顾性分析,对原病理类型按2004年世界卫生组织（World Health Organization,WHO）分型标准重新分型,随访239例患者,生存率的计算及单因素生存分析采用Kaplan-Meier法进行,其间差异性使用Log-rank检验进行计算,所有经单因素生存分析有意义的参数均纳入多因素生存分析Cox回归模型进行计算。结果 随访239例患者,单因素分析结果显示,年龄、有无临床症状、肿瘤切除范围、是否侵犯大血管、WHO组织学分类和Masaoka分期对胸腺瘤患者预后有显著性影响。Cox模型多因素分析显示,肿瘤切除范围（HR=3.25,95%CI：1.747~2.322,P〈0.000 4）、是否侵犯大血管（HR=5.28,95%CI：2.368~10.681,P〈0.000 1）、WHO分型（HR=1.836,95%CI：1.253~3.192,P〈0.005 6）和Masaoka分期（HR=3.129,95%CI：1.964~5.83,P〈0.001 2）是影响胸腺瘤患者远期生存率的独立因素。是否合并重症肌无力对胸腺瘤预后无影响。结论 WHO组织分型、Masaoka分期、肿瘤切除范围和是否侵犯大血管是影响胸腺瘤患者预后的独立因素。OBJECTIVE Thymoma is one of the commonest mediastinal tumors, accounting for about 20%-40% of all adult mediastinal tumor. This article aimed to study the related factors affecting the prognosis of thymoma. METHODS The clinical data of 378 patients with thymoma pathology treated in the Affiliated Tumor Hospital of Guangxi Medical University between 10-01-1985 and 11-30-2012 were analyzed retrospectively. We reclassified original pathological types under the 2004 typing standards of the WHO, then followed up 239 cases. Kaplan-Meier analysis was performed in the calculation of the survival rate and the single factor survival analysis. The differences were calculated by using Log-rank test. All the significant parameters of the single factor survival analysis were included in the multivariate survival analysis, calculated by the Cox multivariate model. RESULTS Through following-up the 239 cases, single factor analysis showed age, clinical symptoms, tumor resection range, violation of large blood vessels, the WHO histological classification, and Masaoka stage had significant effects on thymoma prognosis. Multi factor analysis of Cox model showed, tumor resection range （HR=3.25, 95CI：1. 747-2. 322,P=0. 000 4） ,violation of large blood vessels （HR=5.28, 95%CI：2.368-10. 681,P〈0.001）, the WHO histological classification （HR=1.836,95%CI：1. 253-3. 192,P= 0. 005 6）, and the Masaoka stage（ HR = 3. 129,95% CI： 1. 964 - 5. 83, P = 0. 001 2）, were independent factors which could affect long-term survival in patients with thymoma. The combination of myasthenia gravis had no effect on the prognosis of thymoma. CONCLUSION The WHO histological classification,the Masaoka stage, tumor resection range, violation of large blood vessels are independent factors affecting the prognosis of patients with thymoma.

关 键 词：胸腺肿瘤 WHO组织分型 Masaoka分期 预后 

分 类 号：R736.3[医药卫生—肿瘤]