Value of CT manifestations in distinguishing high risk thymoma from thymoma carcinoma
Objective To explore the value of CT manifestations in the differential diagnosis of high-risk thymoma and thy-moma carcinoma,and to provide evidence for the selection of clinical treatment and prognosis.Methods The clinical data of patients diagnosed with high-risk thymoma(n=60)and thymoma(n=99),confirmed through puncture or surgical pa-thology at Shandong Cancer Hospital between June 1,2022,and March 1,2023,were retrospectively analyzed.Independent diagnostic factors of thymus tumor nature were evaluated by logistic regression analysis,and discriminant models were constructed,and the discriminant effect of the model was evaluated by receiver operating characteristic curve(ROC),sen-sitivity and specificity.Results The mean age of the high-risk thymoma patients(52.73±15.21)years was lower than that of the thymoma patients(56.76±13.18)years,t=1.760,P=0.080.Significant differences were also observed in gender(x2=12.609,P＜0.001),lobulation(x2=6.864,P=0.009),reinforcement method(x2=11.234,P=0.001),peri-cardial effusion(x2=6.496,P=0.011),lymph node metastasis(x2=40.178,P＜0.001),invasion of pericardium(x2=26.157,P＜0.001),invasion of lung tissue(x2=23.964,P＜0.001),invasion of large blood vessels(x2=9.095,P=0.003),lung metastasis(x2=5.464,P=0.019),diaphragmatic elevation(x2=7.662,P=0.006),and myasthenia(x2=10.895,P=0.001).Logistic multivariate analysis showed lymph node metastasis(OR=20.956,95％CI:5.465～80.349,P＜0.001),invasion of lung tissue(OR=2.841,95％CI:1.024～7.886,P=0.045),elevation of diaphragm(OR=4.673,95％CI:1.032～21.173,P=0.045)were independent distinguishing factors for high-risk thymoma and thymoma carcinoma.ROC curve showed that the AUC value of the Logistic regression model was 0.851,95％CI:0.791～0.911,sensitivity was 0.636,and specificity was 0.933.Conclusion CT manifestations are of great value in distinguishing high risk thymoma and thymoma carcinoma.Lymph node metastasis,invasion of lung tissue and elevation of diaphragm are im-portant signs in the diagnosis of thymus carcinoma.
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