Department of Radiology, Lanzhou University Second Hospital, Gansu, China.
Second Clinical School, Lanzhou University, Gansu, China.
Eur J Cardiothorac Surg. 2022 Mar 24;61(4):742-748. doi: 10.1093/ejcts/ezab349.
Our goal was to investigate the correlation of clinical and computed tomography (CT) features of thymic epithelial tumours (TET) with the World Health Organization classification and the Masaoka-Koga staging system.
Clinical and CT imaging data from 159 patients surgically and pathologically diagnosed with TET (82 men, 77 women; mean [± standard deviation] age, 52.08 ± 11.76 years) were retrospectively collected and reviewed. CT features were evaluated by radiologists. Tumour size, morphology, margin, density, calcification, cystic necrosis, density of the fat layer around the tumour, invasion of surrounding tissues, mediastinal lymph node enlargement, pleural/pericardial effusion, metastasis, plain CT scans and enhanced CT values were analysed.
Of the 159 patients with TET, 76 had low-risk thymoma, 55 had high-risk thymoma and 28 had thymic carcinomas. Age, maximum tumour diameter, myasthenia gravis, morphology, edges, density, fat around the lesion, mediastinal vascular, pericardial and lung tissue invasion, pleural/pericardial effusion, metastasis and arterial phase CT values were statistically different among the 3 groups (P < 0.05). Multivariate regression analysis revealed that edges, fat around the lesion, mediastinal vascular invasion and pericardial effusion were most relevant to TET classification. The 159 patients with TET were categorized into the non-invasion group (stage I; n = 58); the invasion of surrounding fat (stage II; n = 46); and the invasion of surrounding structures and metastasis group (stages III and IV; n = 55). Tumour diameter, morphology, margins, density, cystic degeneration and necrosis, invasion of surrounding fat and structure, pleural and pericardial effusion and lymph node enlargement were statistically different among the 3 groups (P < 0.05). Multivariate regression analysis revealed that edges, fat around the lesion, mediastinal vascular invasion and pleura invasion were the most relevant CT signs in relation to TET staging.
Analysis of clinical and CT features before surgery may facilitate the preliminary classification and stage diagnosis of TET.
本研究旨在探讨胸腺瘤（TET）的临床和计算机断层扫描（CT）特征与世界卫生组织（WHO）分类和 Masaoka-Koga 分期系统的相关性。
回顾性收集并分析了 159 例经手术和病理证实的 TET 患者（男 82 例，女 77 例；平均年龄 52.08±11.76 岁）的临床和 CT 影像学资料。由放射科医生评估 CT 特征。分析肿瘤大小、形态、边缘、密度、钙化、囊变坏死、肿瘤周围脂肪层密度、周围组织侵犯、纵隔淋巴结肿大、胸腔/心包积液、转移、平扫 CT 值和增强 CT 值。
159 例 TET 患者中，低危胸腺瘤 76 例，高危胸腺瘤 55 例，胸腺癌 28 例。年龄、最大肿瘤直径、重症肌无力、形态、边缘、密度、病变周围脂肪、纵隔血管、心包和肺组织侵犯、胸腔/心包积液、转移和动脉期 CT 值在 3 组间差异有统计学意义（P<0.05）。多因素回归分析显示，边缘、病变周围脂肪、纵隔血管侵犯和心包积液与 TET 分类最相关。159 例 TET 患者分为非侵犯组（Ⅰ期；n=58）、周围脂肪侵犯组（Ⅱ期；n=46）和周围结构侵犯及转移组（Ⅲ期和Ⅳ期；n=55）。肿瘤直径、形态、边缘、密度、囊变坏死、周围脂肪和结构侵犯、胸腔和心包积液及淋巴结肿大在 3 组间差异有统计学意义（P<0.05）。多因素回归分析显示，边缘、病变周围脂肪、纵隔血管侵犯和胸膜侵犯是与 TET 分期最相关的 CT 征象。
术前分析临床和 CT 特征可能有助于 TET 的初步分类和分期诊断。
