胸腺上皮肿瘤WHO简化病理分型与临床、CT征象的相关性  

Correlation between WHO simplified pathological classification and clinical and CT features of thymic epithelial tumors

作　　者：刘付裕玲 陈凯[1] 李靖煦[1] 潘小环 关玉宝[2] 刘远明 LIU Fuyuling;CHEN Kai;LI Jingxu;PAN Xiaohuan;GUAN Yubao;LIU Yuanming(Department of Radiology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;Department of Radiology,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510700,China;Shenzhen Smart Imaging Healthcare Co.Ltd.,Shenzhen,Guangdong Province 518000,China)

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120 [2]广州医科大学附属第五医院医学影像科,广东广州510700 [3]深圳市智影医疗科技有限公司,广东深圳518000

出　　处：《实用放射学杂志》2021年第9期1429-1432,共4页Journal of Practical Radiology

基　　金：广东省科技计划项目(2017A040405065);深圳市海外高层次人才创新创业专项资金资助项目(KQTD2017033110081833).

摘　　要：目的分析胸腺上皮肿瘤(TET)WHO简化病理分型与临床、CT征象的相关性.方法回顾性分析305例经手术或穿刺病理确诊为TET患者的病理、临床特征及CT征象,根据2015 WHO分型将TET简化分为低危组(A、AB、B1)、高危组(B2、B3)和胸腺癌组,分析WHO简化病理分型与临床特征、CT征象的相关性.结果女性在低危组发病率较高危组及胸腺癌组更高(P<0.05).胸腺癌组平均年龄最大,高危组最年轻(P<0.05).胸腺癌组较低危组及高危组更易出现胸痛(P<0.05).重症肌无力仅见于胸腺瘤,且高危组较低危组多见(P=0.001).病灶形态及对纵隔脂肪间隙、胸膜、大血管的侵犯在3组间有明显统计学差异(P<0.05).胸腺癌组较高危组病灶更大(P=0.015).高危组、胸腺癌组比低危组更易出现坏死、囊变(P<0.05).胸腺癌组比低危组、高危组更易出现不均匀强化和纵隔淋巴结肿大(P<0.05).钙化、分隔样强化、胸腔积液或心包积液在3组间无统计学差异(P>0.05).结论TET的WHO简化病理分型与临床、CT征象存在一定相关性,可结合患者的年龄、胸痛、重症肌无力、病灶的大小、形态、坏死、囊变、不均匀强化、纵隔淋巴结肿大和对纵隔脂肪间隙、胸膜、大血管的侵犯综合评估,提高术前鉴别能力.Objective To analyze the correlation between the WHO simplified pathological classification and clinical and CT features of thymic epithelial tumors(TET).Methods The clinical and CT features of 305 patients with TET pathologically confirmed by surgery or biopsy were analyzed retrospectively.TET were simplified into low-risk(A,AB,B1),high-risk(B2,B3),and thymic carcinoma groups according to the WHO 2015 classification,and the correlation between the WHO simplified pathological classification and clinical features and CT signs were analyzed.Results The incidence of affected females in the low-risk group was higher compared with the high-risk and thymic carcinoma groups(P<0.05).The average age of the thymic carcinoma group was highest,while the high-risk group had the lowest average age(P<0.05).Chest pain was more likely to occur in the thymic carcinoma group compared with the low-risk and high-risk groups(P<0.05).Myasthenia gravis was only found in the cases with thymoma and was more common in the high-risk group compared with the low-risk group(P=0.001).There were statistically significant differences in lesion contour and invasion of mediastinal fat space,pleura,and great vessels among the three groups(P<0.05).The thymic carcinoma group had larger lesions compared with the high-risk group(P=0.015).Necrosis and cystic degeneration were more frequently observed in the high-risk and thymic carcinoma groups compared with the low-risk group(P<0.05).Heterogeneous enhancement and mediastinal lymph node enlargement were more frequently observed in the thymic carcinoma group compared with the low-risk and high-risk groups(P<0.05).There were no statistically significant differences in calcification,septal enhancement,pleural effusion,or pericardial effusion among the three groups(P>0.05).Conclusion There is a correlation between the WHO simplified pathological classification and clinical and CT features of TET.Comprehensive evaluation is beneficial to improve preoperative differentiation by analyzing the age of patients,ch

关 键 词：胸腺上皮肿瘤 组织病理学 计算机体层成像 

分 类 号：R736.3[医药卫生—肿瘤] R446.8[医药卫生—临床医学]