Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chiba, 260-8670, Japan.
Surg Today. 2024 Feb;54(2):162-167. doi: 10.1007/s00595-023-02719-4. Epub 2023 Jun 20.
Preoperative investigations to detect invasion to neighboring organs are important for deciding on the most appropriate surgical approach for thymoma. We evaluated preoperative computed tomography (CT) findings in thymoma patients to identify the CT features associated with tumor invasion.
Clinicopathologic information on 193 patients who underwent surgical resection for thymoma at Chiba University Hospital between 2002 and 2016 was collected retrospectively. The surgical pathology identified invasion of thymoma in 35 patients: in the lung (n = 18), pericardium (n = 11), or both (n = 6). Contact lengths between the tumor contour and lung (CLTL) or pericardium (CLTP) were measured at the maximum section of the tumor on axial CT. Univariate and multivariate analyses were performed to analyze the relationship between pathological invasion of the lung or pericardium and the clinicopathologic features.
The mean CLTL and CLTP were significantly longer in patients with invasion of the neighboring organs than in those without invasion. A lobulated tumor contour was identified in 95.6% of the patients with invasion of the neighboring organs. A multivariate analysis revealed that a lobulated tumor contour was significantly associated with both lung and pericardial invasion.
A lobulated tumor contour was significantly associated with lung and/or pericardial invasion in thymoma patients.
术前检查以发现邻近器官侵犯对于决定胸腺瘤最合适的手术方法非常重要。我们评估了胸腺瘤患者的术前计算机断层扫描（CT）表现，以确定与肿瘤侵犯相关的 CT 特征。
回顾性收集了 2002 年至 2016 年在千叶大学医院接受手术切除胸腺瘤的 193 例患者的临床病理资料。手术病理结果显示 35 例患者存在胸腺瘤侵犯：侵犯肺（n=18）、侵犯心包（n=11）或两者均侵犯（n=6）。在轴向 CT 的肿瘤最大截面处测量肿瘤轮廓与肺（CLTL）或心包（CLTP）的接触长度。进行单因素和多因素分析，以分析肺或心包邻近器官侵犯与临床病理特征之间的关系。
邻近器官侵犯患者的平均 CLTL 和 CLTP 明显长于无侵犯患者。95.6%的邻近器官侵犯患者的肿瘤轮廓呈分叶状。多因素分析显示，分叶状肿瘤轮廓与肺和心包侵犯均显著相关。
分叶状肿瘤轮廓与胸腺瘤患者的肺和/或心包侵犯显著相关。
