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目的 探讨影响胸腺瘤的诊断与预后的相关因素。方法 回顾性分析 135例胸腺瘤患者的临床资料 ,logistic回归分析影响肿瘤复发的相关因素。 结果 胸腺瘤的临床表现多样 ,最常见的是重症肌无力 (6 6 / 135 ,4 8 9% )。出现上腔静脉压迫症状提示肿瘤为恶性 (χ2 =8 373,P =0 0 0 4 )。病程长、男性患者患恶性胸腺瘤的可能性较大 (U =16 91 5 ,P =0 0 13;χ2 =6 12 5 ,P =0 0 13)。胸腺瘤是否钙化及坏死与肿瘤的良恶性无关 (χ2 =0 12 1,P =0 72 8;χ2 =0 4 87,P =0 4 85 )。肿瘤的复发与患者的病程和Masaoka分期呈正相关 [Exp(b) =1 0 5 0、6 72 8,P =0 0 38、0 0 0 3],年龄小、女性患者复发机会小。胸腺瘤复发率Ⅰ期为 2 7% ,Ⅱ期为 11 1% ,Ⅲ期为 30 4 % ,Ⅳ期为 83 3%。结论 胸腺瘤是一种起病隐匿、表现多样的疾病 ,其影像学表现对良恶性的判断欠准确 ,Masaoka分期能提示患者的预后 ;尽早手术治疗有助于改善患者的预后
Objective To explore the factors influencing the diagnosis and prognosis of thymoma. Methods The clinical data of 135 patients with thymoma were retrospectively analyzed. Logistic regression analysis was used to analyze the influencing factors of tumor recurrence. Results The clinical manifestations of thymoma varied. The most common was myasthenia gravis (66/135, 489%). The presence of superior vena cava oppression suggests that the tumor is malignant (χ2 = 8 373, P = 0 0 0 4). Long course of disease, male patients with malignant thymoma is more likely (U = 16 91 5, P = 0 0 13; χ 2 = 6 12 5, P = 0 0 13). Whether thymoma calcification and necrosis has nothing to do with the benign and malignant tumor (χ2 = 0 12 1, P = 0 728; χ2 = 0 477, P = 0 4 85). The relapse of the tumor was positively correlated with the duration of the disease and the Masaoka staging [Exp (b) = 105 0,6 72 8, P = 0 38, 0 0 0 3]. The younger the female, the less chance of recurrence was. The recurrence rate of thymoma was 27% in stage I, 11 1% in stage II, 30 4% in stage III and 83 3% in stage IV. Conclusion Thymoma is a kind of occult onset and manifestation of various diseases. The imaging findings of the thymoma are not good for the judgment of benign and malignant. Masaoka staging can indicate the prognosis of the patients. Early surgical treatment can improve the prognosis of the patients