胸腺瘤WHO分型和Masaoka分期的影响因素分析

An analysis of influencing factors for WHO classification and Masaoka stage of thymoma

目的分析胸腺瘤WHO分型和Masaoka分期的影响因素。方法96例经手术切除的胸腺瘤患者,根据WHO分型分为良性(A、AB型,38例)和恶性(B1、B2、B3及C型,58例),根据Masaoka分期分为早中期(Ⅰ、Ⅱ期,71例)和晚期(Ⅲ、Ⅳ期,25例)。分析胸腺瘤WHO分型和Masaoka分期与临床指标的关系,采用logistic回归分析胸腺瘤WHO分型和Masaoka分期的影响因素。结果与良性胸腺瘤患者比较,恶性胸腺瘤患者年龄较小,重症肌无力比例较高(P<0.05)。早中期和晚期胸腺瘤患者肿瘤最大横径、BMI和淋巴细胞计数比较有统计学差异(P<0.05)。多因素logistic回归分析发现,重症肌无力和Masaoka分期晚期是恶性胸腺瘤的独立危险因素,年龄较大是其保护性因素(P<0.05)。淋巴细胞计数较高是晚期胸腺瘤的保护性因素(P<0.05)。结论年龄、Masaoka分期、重症肌无力是胸腺瘤WHO分型的影响因素,淋巴细胞计数是胸腺瘤患者Masaoka分期的影响因素。

Objective To analyze the influencing factors for WHO classification and Masaoka stage of thymoma.Methods According to WHO classification,96 patients with thymoma underwent surgical resection were divided into benign thymoma(type A and AB,38 cases)and malignant thymoma(type B1,B2,B3 and C,58 cases).According to Masaoka stage,the patients were divided into early and middle thymoma(stageⅠandⅡ,71 cases)and advanced thymoma(stageⅢandⅣ,25 cases).The relationship between WHO classification,Masaoka stage and clinical indicators of thymoma was analyzed.The influencing factors for WHO classification and Masaoka stage of thymoma were analyzed by logistic regression analysis.Results Compared to benign thymoma patients,the malignant thymoma patients had younger age and higher proportion with myasthenia gravis(MG)(P<0.05).The maximum tumor diameter,BMI and lymphocyte count were significantly different between the early and middle patients and advanced patients(P<0.05).Multivarite logistic regression analysis showed that MG and advanced thymoma were the independent risk factors and older age was the protective factor for malignant thymoma(P<0.05).High lymphocyte count was the protective factor for advanced thymoma(P<0.05).Conclusion The age,Masaoka stage and MG are the influencing factors for WHO classification of thymoma,and lymphocyte count of thymoma is an influencing factors for Masaoka stage of thymoma.