Cheng Zixuan, Yu Fuhuan, Chen Ruao, Cui Lingjun, Chen Yingying, Deng Chao, Shi Yanfen, Tan Huangying
Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China.
Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing 100029, China.
Cancers (Basel). 2024 Jul 10;16(14):2502. doi: 10.3390/cancers16142502.
Thymic neuroendocrine tumors (Th-NETs) are rare and aggressive, with a scarcity of research on predicting patient prognosis. Our study aimed to assess the impact of prognostic markers and temozolomide (TMZ)-based chemotherapy on survival in Th-NETs.
We retrospectively reviewed the medical records of patients diagnosed with Th-NETs between 2013 and 2023 at our institution. We collected clinicopathological data, including tumor pathological grading, staging, serum concentrations of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide, levels of inflammatory factors, and expression of oxygen 6-methylguanine-DNA methyltransferase (MGMT). Treatment details (such as surgery and chemotherapy) and survival outcomes were also documented.
A total of 32 patients were included in our study after excluding those without complete available information. The median progression-free survival (PFS) was 12.5 months (95%CI, 8-16 months) for 19 patients who received TMZ-based chemotherapy. Twenty-one patients underwent surgery as the primary treatment, demonstrating a median disease-free survival (DFS) of 51.0 months. The inflammatory factor neutrophil-to-lymphocyte ratio (NLR) was an independent prognostic indicator of DFS in postoperative patients and PFS in TMZ-treated patients. The overall 3-, 5-, and 10-year survival rates were 86.6%, 69.5%, and 33.8%, respectively. Ki67 level exceeding 10% ( = 0.048) and absence of surgical resection ( = 0.003) were significantly associated with worse overall survival (OS).
Surgical treatment was currently the primary method for treating Th-NETs, and postoperative adjuvant therapy was an essential consideration for specific patient cohorts. Despite widespread positive MGMT expression, TMZ-based chemotherapy showed promise. Some potential prognostic biomarkers such as NLR and NSE need more attention.
胸腺神经内分泌肿瘤（Th-NETs）罕见且具有侵袭性，关于预测患者预后的研究较少。我们的研究旨在评估预后标志物和基于替莫唑胺（TMZ）的化疗对Th-NETs患者生存的影响。
我们回顾性分析了2013年至2023年在我院诊断为Th-NETs的患者的病历。我们收集了临床病理数据，包括肿瘤病理分级、分期、神经元特异性烯醇化酶（NSE）和胃泌素释放肽前体的血清浓度、炎症因子水平以及氧6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）的表达。还记录了治疗细节（如手术和化疗）及生存结果。
排除信息不完整的患者后，共有32例患者纳入我们的研究。19例接受基于TMZ化疗的患者的中位无进展生存期（PFS）为12.5个月（95%CI，8 - 16个月）。21例患者接受手术作为主要治疗，中位无病生存期（DFS）为51.0个月。炎症因子中性粒细胞与淋巴细胞比值（NLR）是术后患者DFS和TMZ治疗患者PFS的独立预后指标。总体3年、5年和10年生存率分别为86.6%、69.5%和33.8%。Ki67水平超过10%（P = 0.048）和未进行手术切除（P = 0.003）与较差的总生存期（OS）显著相关。
手术治疗目前是治疗Th-NETs的主要方法，术后辅助治疗是特定患者群体的重要考虑因素。尽管MGMT广泛呈阳性表达，但基于TMZ的化疗显示出前景。一些潜在的预后生物标志物如NLR和NSE需要更多关注。
