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胸腺瘤的钙化可以预测对周围器官的侵袭

已有 198 次阅读2021-10-14 11:19 |个人分类:TET学习|系统分类:医学科学| 胸腺瘤

胸腺瘤的钙化可以预测对周围器官的侵袭.
Calcification in thymomas can predict invasiveness to surrounding organs
背景:胸腺瘤是最常见的前纵隔肿瘤类型。有时使用计算机断层扫描 (CT) 在胸腺瘤中观察到钙化,并且在侵袭性胸腺瘤中比在非侵袭性胸腺瘤中更常见。然而,胸腺瘤钙化的意义仍然未知。本研究旨在评估胸腺瘤钙化对周围器官侵袭的意义,并调查我院胸腺瘤钙化病例的特征。

方法:我们纳入了 2000 年至 2016 年在我们机构接受治疗的胸腺瘤患者,并评估了他们的特征,包括人口统计学、CT 钙化、组织学、Masaoka 分期和重症肌无力状态。将患者分为钙化(C)组和非钙化(NC)组。

结果:纳入的51例患者中,11例(21.6%)有钙化。与 A、AB 和 B1 型肿瘤(低风险;p = 0.0477)相比,C 组患者中世界卫生组织 B2 和 B3 型肿瘤(高风险)的比例更高。 C 组 Masaoka III 和 IV 期患者的数量显着高于 NC 组(p < 0.0001)。 C组患者对纵隔胸膜、心包、肺、膈神经、胸壁和胸膜播散的侵犯率明显高于NC组患者。

结论:钙化反映肿瘤对周围器官和组织的侵袭性,因此可以预测胸腺瘤分期和组织学上高危的胸腺瘤。胸腺瘤钙化还可以预测病理分期,并根据CT结果根据钙化状态帮助决定治疗胸腺瘤的治疗方法和手术方法。

图1:胸腺瘤中不同的钙化形式。 我们将钙化分为结节状(我们可以在节点周围追踪,大小大约 >3 mm)、点状(大小大约 <3 mm)和环形钙化

Background: Thymomas are the most common type of anterior mediastinal tumors. Calcification is sometimes observed in thymomas using computed tomography (CT), and it is more frequent in invasive thymomas than in noninvasive thymomas. However, the significance of calcification in thymomas remains unknown. This study aimed to evaluate the significance of calcification in thymomas on invasiveness to surrounding organs and investigate the characteristics of thymoma cases with calcification at our institution.

Methods: We included thymoma patients treated at our institution between 2000 and 2016, and evaluated their characteristics, including demographics, calcification on CT, histology, Masaoka stage, and myasthenia gravis status. The patients were categorized into calcification (C) and noncalcification (NC) groups.

Results: Among 51 included patients, 11 (21.6%) had calcification. A higher proportion of group C patients had World Health Organization histological type B2 and B3 tumors (high-risk) than type A, AB, and B1 tumors (low-risk; p = 0.0477). The number of patients with Masaoka stages III and IV were significantly higher in the C group than in the NC group (p < 0.0001). The C group patients had significantly higher rates of invasion to the mediastinal pleura, pericardium, lung, phrenic nerve, and chest wall and pleural dissemination than the NC group patients.

Conclusions: Calcification reflects invasiveness of tumors to surrounding organs and tissues, and may thus predict thymoma stage and histologically high-risk thymomas. Calcification in thymomas may also predict the pathological stage and help decide therapeutic methods and surgical approaches to treat thymomas based on the calcification status according to CT findings.

Keywords: calcification; computed tomography; thymoma.

Yoshida M, Kondo K, Miyamoto N, Kawakami Y, Tangoku A. Calcification in thymomas can predict invasiveness to surrounding organs. Thorac Cancer. 2021 Jun;12(12):1857-1863. doi: 10.1111/1759-7714.13964. Epub 2021 May 6. PMID: 33955164; PMCID: PMC8201533.

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回复 hyc3140 2021-10-14 11:44
Liu L, Lu F, Pang P, Shao G. Can computed tomography-based radiomics potentially discriminate between anterior mediastinal cysts and type B1 and B2 thymomas? Biomed Eng Online. 2020 Nov 27;19(1):89. doi: 10.1186/s12938-020-00833-9. PMID: 33246468; PMCID: PMC7694435.

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