胸腺上皮性肿瘤组织学分型与CT征象的相关性研究

Correlation between histological classification of thymic epithelial tumors and CT signs

目的探讨胸腺上皮性肿瘤(TET)组织学分型与CT征象的相关性。方法选取64例经病理确诊为TET患者的临床及影像资料,根据WHO 2015年标准进行组织学分型,然后分析不同组织学类型的TET CT特点。结果64例TET患者中,A型8例(12.5%)、AB型6例(9.4%)、B1型15例(23.4%)、B2型22例(34.4%)、B3型8例(12.5%)、胸腺癌5例(7.8%)。胸腺癌组病灶体积普遍大于低、高危组(P<0.05),高危组及胸腺癌组较低危组相比病灶形态更不规则(P<0.05),胸腺癌组较其他组比较边界多不清晰,且更易侵犯周围组织和发生淋巴结及远处转移(P<0.05),而低危组与高危组差异无统计学意义(P>0.05),三组间强化程度、囊变坏死率、钙化发生率无明显差异(P>0.05)。结论TET组织学分型与CT征象间存在一定相关性,可通过分析病灶大小、形态、边界、与周围组织的关系及转移情况来判断肿瘤的侵袭性和组织学分型。

Objective To investigate the correlation between histological classification of thymic epithelial tumor(TET)and CT signs.Methods The clinical and imaging data of 64 patients with pathologically confirmed TET were retrospectively analyzed.Histological classification was performed according to the WHO 2015 standard,and then,the CT characteristics of TET of different histological types were analyzed.Results Of the 64 TET patients,8 were A(12.5%),6 were AB(9.4%),15 were B1(23.4%),22 were B2(34.4%),and 8 were B3(12.5%),5 cases were thymic cancer(7.8%).Thymic cancer group lesions were generally larger than low and high risk groups(P<0.05).The morphology of lesions in the high-risk group and the thymic cancer group was more irregular than that in the low-risk group(P<0.05).Compared with other groups,the thymic cancer group had more unclear boundaries,and was more likely to invade surrounding tissues and to develop lymph nodes and distant metastases(P<0.05),while the low-risk group was not significantly different from the high-risk group(P>0.05).There were no significant differences between the three groups in strengthening,cystic necrosis rate,and incidence of calcification(P>0.05).Conclusion There is a certain correlation between histological typing of TET and CT signs.The tumor's aggressiveness and histological typing can be judged by analyzing the size,shape,border,relationship with surrounding tissues and metastasis.