Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, South Korea.
Cancer Research Institute, Seoul National University, Seoul, South Korea.
Thorac Cancer. 2019 Apr;10(4):864-871. doi: 10.1111/1759-7714.13016. Epub 2019 Feb 21.
The growth rate of thymic epithelial tumors (TETs) and thymic cysts was investigated to determine whether they can be differentiated and clinico-radiological predictors of interval growth was identified.
This retrospective study included 122 patients with pathologically proven thymic cysts (n = 56) or TETs (n = 66) who underwent two serial chest computed tomography scans at least eight weeks apart. Average diameters and attenuation were measured, volume-doubling times (VDTs) were calculated, and clinical characteristics were recorded. VDTs were compared using the log-rank test. Predictors of growth were analyzed using the log-rank test and Cox regression analysis.
The frequency of growth did not differ significantly between TETs and thymic cysts (P = 0.279). The VDT of thymic cysts (median 324 days) was not significantly different from that of the TETs (median 475 days; P = 0.808). Water attenuation (≤ 20 Hounsfield units) predicted growth in thymic cysts (P = 0.016; hazard ratio 13.2, 95% confidence interval 1.6-107.3), while lesion size (> 17.2 mm) predicted growth in TETs (P = 0.008 for size, P = 0.029 for size*time). For the growing lesions, the positive and negative predictive values of water attenuation for thymic cysts were 93% and 80%, respectively.
The frequencies of interval growth and VDTs were indistinguishable between TETs and thymic cysts. Water attenuation and lesion size predicted growth in thymic cysts and TETs, respectively. Among the growing lesions, water attenuation was a differential feature of thymic cysts.
研究了胸腺瘤（TETs）和胸囊的生长速度，以确定它们是否可以区分，并确定临床和影像学的间隔生长预测因子。
本回顾性研究纳入了 122 例经病理证实的胸囊（n=56）或 TETs（n=66）患者，他们至少间隔 8 周进行了两次连续的胸部 CT 扫描。测量平均直径和衰减值，计算体积倍增时间（VDT），并记录临床特征。使用对数秩检验比较 VDT。使用对数秩检验和 Cox 回归分析分析生长的预测因子。
TETs 和胸囊的生长频率无显著差异（P=0.279）。胸囊的 VDT（中位数 324 天）与 TETs 的 VDT（中位数 475 天；P=0.808）无显著差异。水衰减（≤20 亨氏单位）预测胸囊的生长（P=0.016；危险比 13.2，95%置信区间 1.6-107.3），而病变大小（>17.2mm）预测 TETs 的生长（P=0.008 用于大小，P=0.029 用于大小*时间）。对于生长的病变，水衰减对胸囊的阳性和阴性预测值分别为 93%和 80%。
TETs 和胸囊的间隔生长频率和 VDT 无显著差异。水衰减和病变大小分别预测了胸囊和 TETs 的生长。在生长的病变中，水衰减是胸囊的一个鉴别特征。
