Surgical treatment and prognostic analysis of thymoma of 354 cases
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摘要:
目的：分析并探讨影响接受外科治疗的胸腺瘤患者预后的临床、病理等因素。方法：回顾性分析南京医科大学第一附属医院胸外科2008年1—6月收治的胸腺瘤患者354例，评估分析年龄、性别、肿瘤直径、世界卫生组织（World Health Organization，WHO）病理分型、TNM分期、Masaoka-Koga分期、重症肌无力、根治性切除对患者预后的影响。结果：Kaplan-Meier单因素生存分析显示：年龄（P=0.002）、肿瘤直径（P=0.045）、WHO病理分型（P=0.051）、TNM分期（P=0.004）、Masaoka-Koga分期（P < 0.001）、根治性切除（P < 0.001）与患者预后相关。Cox多因素生存分析显示，年龄（P=0.003，危害比：10.151，95%CI：2.239~46.021）、WHO病理分型（P=0.045，危害比：3.376，95%CI：1.030~11.064）、Masaoka-Koga分期（P=0.009，危害比：5.621，95%CI：1.552~20.352）是影响胸腺瘤患者总体生存的独立预后因素。结论：胸腺瘤的早期诊断可以有效提高其外科治疗效果，积极实行根治性切除是改善胸腺瘤患者预后的重要手段，术后准确的病理分析可帮助临床医生预测患者预后。
Abstract:
Objective：This study aims to investigate the prognostic significance of the clinical，pathological and treatment factors on the thymoma patients accepted surgical treatment. Methods：Retrospective analysis was performed on 354 patients with thymoma undergoing surgical treatment between January 2008 and June 2018. The association between the prognostic factors and survival was assessed using the Kaplan-Meier method. Results：Kaplan-Meier analysis showed that age（P=0.002），tumor size（P=0.045），pathological type（P=0.051），TMN stage（P=0.004），Masaoka-Koga stage（P < 0.001），radical resection（P < 0.001）were related to the prognosis of patients with thymoma. Age（P=0.003，hazard ratio：10.151，95% CI：2.239~46.02），pathological type（P=0.045，hazard ratio：3.376，95% CI：1.030~11.064），Masaoka-Koga stage（P=0.009，hazard ratio：5.621，95% CI：1.552~20.352）was also validated as an independent prognostic factor in multivariate Cox analysis. Conclusion：The early detection of thymoma can effectively improve the overall survival of the thymoma patients after surgical treatment. Radical resection is an important factor to improve the prognosis of patients with thymoma. Accurate pathological analysis after surgery can help analyze the prognosis of patients with thymoma.
