胸腺神经内分泌肿瘤生存及预后因素分析

Analysis of survival and prognostic factors of neuroendocrine tumors of the thymus

目的 探讨胸腺神经内分泌肿瘤(NETTs)的临床病理特征及生存预后影响因素。方法 选取2011年9月至2021年10月在郑州大学第一附属医院经穿刺或手术病理诊断为NETTs的患者69例,回顾性分析其临床病理特征及对预后的影响。结果 入组69例患者主要为男性(78.3%),中位年龄为53岁,中位总生存期(OS)为49.5个月,病灶直径中位值为6.85 cm,最常见的首发症状是胸部不适(42.1%)。单变量分析显示,Ki-67指数(χ^(2)=15.817,P<0.001)、病理分级(χ^(2)=18.440,P<0.001)、病理分期(χ^(2)=8.666,P=0.004)和是否手术(χ^(2)=6.026,P=0.014)与患者OS有关。多变量分析显示,病理分级是OS的独立危险因素(HR=7.133,95%CI:2.183~23.306,P=0.001)。手术是疾病无进展生存期(PFS)的影响因素(P=0.009)。结论 NETTs是罕见恶性肿瘤,手术可以改善患者PFS,低病理分级是预后不良的独立危险因素。

Objective To investigate the clinical characteristics of neuroendocrine tumors of the thymus(NETTs),and to identify prognostic factors.Methods The data of 69 patients diagnosed with NETTs by puncture or surgical pathology in the First Affiliated Hospital of Zhengzhou University from September 2011 to October 2021 were retrospectively reviewed.Clinicopathological characteristics and their impact on prognosis were analyzed.Results The 69 patients enrolled were mainly male(78.3%),with a median age of 53 years old,a median overall survival period(OS)of 49.5 months,and a median lesion diameter of 6.85 cm.The most common initial symptom was chest discomfort(42.1%).Univariate analysis showed that the Ki-67 index(χ^(2)=15.817,P<0.001),pathological grade(χ^(2)=18.440,P<0.001),pathological stage(χ^(2)=8.666,P=0.004)and surgery or not(χ^(2)=6.026,P=0.014)were associated with OS.Multivariate analysis showed that pathological grading was an independent risk factor for OS(HR=7.133,95%CI:2.183-23.306,P=0.001).Surgery was a contributing factor to disease progression free survival(PFS,P=0.009).Conclusion NETTs are rare malignancies,surgery could improve the PFS,and poorly pathological grade is an independent factor for poor prognosis.