摘要
目的分析胸腺上皮肿瘤WHO组织分型与CT表现的相关性。方法搜集经手术病理证实胸腺上皮肿瘤100例,根据2015 WHO胸腺上皮肿瘤进行分型,分为低危组（A、AB、B1）,高危组（B2、B3）,胸腺癌组。由两位放射科医师采用盲法对肿瘤CT表现分别从肿瘤大小、轮廓、形状、密度、钙化、强化方式、强化程度、邻近结构侵犯,胸腔积液、心包积液、转移方面进行分析,分析不同CT影像表现与组织病理分型的相关性,并对Masaoka临床分期与组织病理分型相关性进行分析。结果性别与年龄在低危组、高危组、胸腺癌组三组分布中无统计学差异（P〉0.05）。重症肌无力在高危组所占比例明显高于低危组及胸腺癌组,有统计学差异（P=0.000）。病灶大小及轮廓分别在三组间有明显统计学差异（P=0.000）。低危组、高危组、胸腺癌组三组在形态、密度、钙化、强化方式、强化程度方面无明显统计学差异（P〉0.05）。邻近纵隔脂肪浸润、侵犯大血管、胸膜种植、心包种植、纵隔淋巴结增大、远处转移在三组之间有明显统计学差异（P〈0.05）。胸腔积液及心包积液在三组中所占比例相仿,无明显统计学差异（P〉0.05）。侵袭性胸腺瘤（Masaoka临床Ⅱ、Ⅲ、Ⅳ期）在低危组、高危组、胸腺癌组中所占的比例随着病理分级逐渐增大。结论大小、轮廓、重症肌无力症状、邻近脂肪间隙浸润、大血管侵犯、胸膜及心包种植、淋巴结及远处转移在鉴别低危组、高危组及胸腺癌组有明显统计学差异,Masaoka临床分期与病理分型有一定相关性。
Objective to analyse the CT finding of thymic epithelial tumors and its correlation with the WHO histopathologic classification. Methods The CT findings of thymic epithelial tumors were retrospectively analyzed in 100 patients who had undergone surgery. Two radiologists,who were unaware of the histopathologic classification made in accordance with 2015 WHO recommendations [low-risk thymomas（ types A,AB,and B1）,high-risk thymomas（ types B2 and B3）,and thymic carcinomas（ type C） ]. The CT fidings were noted in term of the size,contour,shape,density,calcification,enhancement,enhancement degree,mediastinal fat invasion,great vessel invasion,pleural effusion,pericardial effusion,and metastasis. We proceeded to analyse the correlation between different CT findings and histopathological classification and assess the correlation between Masaoka clinical stage and histopathological classification. Results There was no significant difference between sex and age in low risk group,high risk group and thymic carcinoma group（ P 〉 0. 05）. The proportion of myasthenia gravis in the high risk group was significantly higher than that in the low risk group and the thymic carcinoma group（ P = 0. 000）. The size and contour of the lesion were statistically different between the three groups. The diameter of the high-risk group was smaller than that of the low-risk group and the thymic carcinoma group. The low-risk group had smooth contour and the lobulated shape was more common in the high-risk group.（ P = 0. 000）. There were no significant differences in shape,density,calcification,enhancement mode and enhancement degree between low risk group,high risk group and thymic carcinoma group（ P 〉 0. 05）. Mediastinal fat invasion,great vessel invasion,pleural seeding,pericardial seeding,mediastinal lymph node enlargement,distant metastasis between the three groups were statistically significant（ P 〈 0. 05）. Pleural effusion and pericardial effusion in the proportion of the three groups were similar,no significant statistical differences. The proportion of Invasive thymoma（ Masaoka clinical Ⅱ,Ⅲ,Ⅳ） in the low-risk group,highrisk group,thymic cancer with the pathological grade gradually increased. Conclusion The size of the lesion,contour,myasthenia gravis,medistinal fat invasion,great vessel invasion,pleural seeding,pericardial seeding,mediastinal lymph node enlargement,distant metastasis in the identification of low-risk group,high-risk group and thymic cancer were statistically significant differences,So preoperative CT examination can provide a basis for assessing the classification of thymic epithelial tumors. Masaoka clinical staging and thymic epithelial tumors pathological classfication have a certain relevance.
作者
张正平
侯晓婧
牛建栋
郜彩斌
孟淑萍
朱力
ZHANG Zhengping;HOU Xiaojing;NIU Jiandong(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750004,P.R.Chin)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第6期936-940,共5页
Journal of Clinical Radiology
