胸腺上皮性肿瘤的CT表现、Ki-67指数与WHO病理学分型的相关性研究

A Study on The Analysis of Correlations between CT Findings,Ki-67 Index and WHO Pathological Classification for Thymic Epithelial Tumors

目的探讨胸腺上皮性肿瘤(TETs)的CT表现、免疫组织化学Ki-67指数与WHO病理学分型的相关性。方法回顾性分析45例经穿刺活检或手术病理证实的TETs患者的CT基本特征、定量参数值及Ki-67指数,按简化WHO分型将TETs分为低危组胸腺瘤(A、AB、B1型)、高危组胸腺瘤(B2、B3型)和胸腺癌3组进行统计学分析,再对差异有统计学意义的结果进一步两两比较。结果低危组24例,高危组10例,胸腺癌组11例。不同病理学分型TETs的肿瘤形态、强化幅度CT值、邻近组织浸润(纵隔胸膜、心包、血管结构)、纵隔淋巴结肿大差异均有统计学意义(均P<0.05),横断面最长径、密度是否均匀、有无钙化差异均无统计学意义(均P>0.05),Ki-67指数差异有统计学意义(P<0.05)。结论不同病理学分型TETs的CT表现具有一定特征性,在一定程度上可预测TETs的病理类型,Ki-67指数与简化WHO分型具有相关性,可为临床提供更多有价值的信息。

Objective To investigate the correlations between CT findings,immunohistochemical Ki-67 index and WHO pathological classification of thymic epithelial tumors(TETs).Methods 45 TETs patients confirmed by biopsy or postoperative pathology were retrospectively analyzed by basic CT features,quantitative parameters and Ki-67 index.According to simplified WHO classification,TETs patients were divided into three groups:low-risk thymoma group(type A,AB,B1),high-risk thymoma group(type B2,B3)and thymic carcinoma group.Then,after statistical analysis was made among these groups,the results with significant differences were further compared.Results A total of 24 cases were in low-risk group,with 10 cases in high-risk group and 11 cases in thymic carcinoma group.There were statistically different comparing tumor morphology,CT enhancement degree,adjacent tissue infiltration(mediastinal pleura,pericardium and vascular structure)and mediastinal lymph node enlargement among these groups,with P<0.05.However,for the values of longest diameter,density and whether calcifications exist or not,the differences were not statistically significant,with P>0.05.Compared the values of Ki-67 index among these groups,the differences had statistical significance,with P<0.05.Conclusion The CT findings of different pathological types of TETs have their own characteristics,which can help predict the pathological types of TETs.There is a correlation betwenn simplifide WHO classification and Ki-67 index.The two variables can provide more valuable information for clinical practice.