Correlation of Computed Tomography Parameters with Histology, Stage and Prognosis in Surgically Treated Thymomas

The histological classification and staging of thymic tumors remains a matter of debate. The correlation of computed tomography (CT) parameters with tumor histology and stage also still has to be completely assessed. The aim of this study was therefore to analyze the correlation of radiological parameters with histological and staging classifications of thymomas evaluating their prognostic role.
Methods: Data of 50 patients with thymoma submitted to a complete surgical treatment between 2005 and 2015 were retrospectively analyzed. Tumors were classified according to the WHO and Suster and Moran (S&M) histological classifications and to the Masaoka–Koga and tumor, node and metastases (TNM) staging systems. The correlation of CT features with histology and stage and the prognostic role of histopathological and radiological features were assessed.
Results: Five-year overall (OS) and disease-free survival (DFS) were 90.3% and 81.1%, respectively. A significant correlation of DFS with the Masaoka–Koga (p = 0.001) and TNM staging systems (p = 0.002) and with the S&M (p = 0.02) and WHO histological classifications (p = 0.04) was observed. CT scan features correlated with tumor stage, histology and prognosis. Moderately differentiated tumors (WHO B3) had a significantly higher incidence of irregular shape and contours (p = 0.002 and p = 0.001, respectively) and pericardial contact (p = 0.036). A larger tumor volume (p = 0.03) and a greater length of pleural contact (p = 0.04) adversely influenced DFS. The presence of pleural (p < 0.001) or lung invasion (p = 0.02) and of pleural effusion (p = 0.004) was associated with a significantly worse OS.
Conclusions: Pre-operative CT scan parameters correlate with stage and histology, and have a prognostic role in surgically treated thymomas.
doi.org/10.3390/medicina57010010

胸腺肿瘤的病理学分类和分期问题至今仍存在争议。计算机断层扫描（CT）参数与肿瘤组织学及分期之间的相关性亦尚未得到全面评估。因此，本研究旨在分析放射学参数与胸腺瘤的病理学分类和分期之间的相关性，并评估其预后作用。

研究方法：对2005年至2015年间接受完整手术治疗且患有胸腺瘤的50名患者的数据进行回顾性分析。根据世界卫生组织（WHO）和苏斯特及莫兰（S&M）的组织学分类，以及马萨卡-科加（Masaoka–Koga）和肿瘤、淋巴结及转移（TNM）分期系统对肿瘤进行分类。评估了CT特征与组织学、分期以及组织病理学和放射学特征对预后的影响。

研究结果：五年总生存期（OS）和无病生存期（DFS）分别为90.3%和81.1%。DFS与马萨卡-科加（Masaoka–Koga）分期系统（p = 0.001）、TNM分期系统（p = 0.002）、S&M分类（p = 0.02）和WHO组织学分类（p = 0.04）之间存在显著相关性。CT扫描特征与肿瘤分期、组织学及预后相关。中分化肿瘤（WHO B3）不规则形状和轮廓（p = 0.002和p = 0.001）以及心包接触（p = 0.036）的发生率显著较高。更大的肿瘤体积（p = 0.03）和更长的胸膜接触长度（p = 0.04）对DFS产生不利影响。胸膜（p < 0.001）或肺侵犯（p = 0.02）以及胸腔积液（p = 0.004）的存在与显著较差的OS相关。

研究结论：术前CT扫描参数与分期和组织学相关，并在手术治疗的胸腺瘤中具有预后作用。doi.org/10.3390/medicina57010010