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中华胸部外科电子杂志 ›› 2020, Vol. 07 ›› Issue (01) : 17 -21. doi: 10.3877/cma.j.issn.2095-8773.2020.01.003

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论著

胸腺上皮肿瘤WHO分型与系统性免疫炎症指数的相关性
刘勇1, 赵亮1, 徐家行1, 付珺1, 赵轲1, 陈宝钧1,†()   
  1. 1. 430014　华中科技大学同济医学院附属武汉中心医院胸外科
  • 收稿日期:2020-01-06 出版日期:2020-02-28
  • 通信作者: 陈宝钧

Correlation between thymic epithelial tumors and systemic immune-inflammation index based on WHO classification

Yong Liu1, Liang Zhao1, Jiahang Xu1, Jun Fu1, Ke Zhao1, Baojun Chen1,†()   

  1. 1. Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
  • Received:2020-01-06 Published:2020-02-28
  • Corresponding author: Baojun Chen
  • About author:
    Corresponding author: Chen Baojun, Email:
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刘勇, 赵亮, 徐家行, 付珺, 赵轲, 陈宝钧. 胸腺上皮肿瘤WHO分型与系统性免疫炎症指数的相关性[J]. 中华胸部外科电子杂志, 2020, 07(01): 17-21.

Yong Liu, Liang Zhao, Jiahang Xu, Jun Fu, Ke Zhao, Baojun Chen. Correlation between thymic epithelial tumors and systemic immune-inflammation index based on WHO classification[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2020, 07(01): 17-21.

目的

探讨胸腺上皮肿瘤的WHO组织学分型与系统性免疫炎症指数的相关性。

方法

收集2017年1月至2019年12月经手术后病理学检查证实的胸腺上皮肿瘤患者的临床资料。根据WHO(2015版)胸腺上皮性肿瘤分型，将纳入研究的患者分为低危组、高危组和胸腺癌组；以同期接受手术治疗的胸腺良性肿物患者作为对照。所有患者于术前4 d内获取外周血内血小板、中性粒细胞、淋巴细胞计数，计算系统性免疫炎症指数。比较各组间系统性免疫炎症指数的差异，并分析其与肿瘤恶性程度的相关性。

结果

共纳入胸腺上皮性肿瘤患者46例(低危组20例，高危组19例，胸腺癌组7例)和对照组患者34例。胸腺癌组系统性免疫炎症指数显著高于其余三组(P＝0.009)。系统性免疫炎症指数与胸腺上皮性肿瘤的恶性程度显著相关(r＝0.244，P＝0.032)。

结论

系统性免疫炎症指数与基于WHO分型的胸腺上皮性肿瘤恶性程度具有显著相关性，可作为胸腺上皮肿瘤恶性程度的临床预测指标。

关键词: 胸腺上皮性肿瘤, WHO组织学分型, 系统性免疫炎症指数
Objective

To investigate the correlation between thymic epithelial tumors and the systemic immune-inflammation index based on histological classification of World Health Organization.

Methods

From January 2017 to December 2019, 46 cases of thymic epithelial tumors confirmed by operation and pathology were analyzed retrospectively. According to the histological classification of WHO published in 2015, data were divided into low risk thymoma (LRT including type A, AB and B1), high risk thymoma (HRT including type B2 and B3), thymic carcinoma (TC). Patients of benign thymic tumor (BTT) treated by operation at the same time were reviewed as a control group. For all patients, their peripheral blood platelet (P), neutrophil (N), and lymphocyte (L) counts were obtained 4 days before the operation. Indexes were calculated according to SII=P×N/L. The differences between the groups were compared, and the correlation with the degree of malignancy was calculated.

Results

A total of 46 patients with thymic epithelial tumors (20 in the low-risk group, 19 in the high-risk group and 7 in the thymic cancer group) and 34 patients in the control group were included in the research. The SII value of the TC group was significantly higher than the other three groups, P=0.009. SII was significantly correlated with the malignancy of thymic epithelial tumors, with a correlation coefficient of 0.244(P=0.032).

Conclusions

Based on the histological classification of WHO, the malignant degree of thymic epithelial tumor is significantly correlated with the systemic immune- inflammatory index. SII can be used to clinically predict the malignancy of thymic epithelial tumors.

Key words: Thymic epithelial tumor, Histological classification of WHO, Systemic immune-inflammatory index
表1 一般临床资料分析
项目 对照组(N＝34) 低危组(N＝20) 高危组(N＝19) 胸腺癌组(N＝7) P值
性别(n) ? ? ? ? 0.544
? 男性 12 7 10 2 ?
? 女性 22 13 9 5 ?
年龄(岁，＋s) 54.00±13.67 57.40±12.60 54.42±14.20 54.29±9.76 0.628
肿瘤直径(n) ? ? ? ? 0.682
? <3 cm ? 2 0 0 ?
? 3～5 cm ? 4 5 3 ?
? 5～7 cm ? 8 10 3 ?
? >7 cm ? 6 4 1 ?
Masaoka分期(n) ? ? ? ? 0.207
? Ⅰ ? 14 10 4 ?
? Ⅱ ? 5 8 1 ?
? Ⅲ、Ⅳ ? 1 1 2 ?
合并重症肌无力(n) 5 0 5 0 ?
表2 四组间相关指标的比较(±s)
指标 对照组(n＝34) 低危组(n＝20) 高危组(n＝19) 胸腺癌组(n＝7)
血小板计数(×109/L) 206.06±55.99a 199.45±73.51b 209.6±45.35c 262.43±61.00
中性粒细胞计数(×109/L) 2.90±1.01d 3.29±1.18 3.65±1.54 4.38±1.01
淋巴细胞计数(×109/L) 1.66±0.45 1.93±0.88 1.93±0.75 1.57±0.62
SII 379.02±168.92e 401.41±256.22f 483.11±416.17g 763.04±249.35
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