Background: Thymic neuroendocrine tumors (Th-NETs) are rare and aggressive, with a scarcity of research on predicting patient prognosis. Our study aimed to assess the impact of prognostic markers and temozolomide (TMZ)-based chemotherapy on survival in Th-NETs. Methods: We retrospectively reviewed the medical records of patients diagnosed with Th-NETs between 2013 and 2023 at our institution. We collected clinicopathological data, including tumor pathological grading, staging, serum concentrations of neuron-specific enolase (NSE) and pro-gastrin-releasing peptide, levels of inflammatory factors, and expression of oxygen 6-methylguanine-DNA methyltransferase (MGMT). Treatment details (such as surgery and chemotherapy) and survival outcomes were also documented. Results: A total of 32 patients were included in our study after excluding those without complete available information. The median progression-free survival (PFS) was 12.5 months (95%CI, 8–16 months) for 19 patients who received TMZ-based chemotherapy. Twenty-one patients underwent surgery as the primary treatment, demonstrating a median disease-free survival (DFS) of 51.0 months. The inflammatory factor neutrophil-to-lymphocyte ratio (NLR) was an independent prognostic indicator of DFS in postoperative patients and PFS in TMZ-treated patients. The overall 3-, 5-, and 10-year survival rates were 86.6%, 69.5%, and 33.8%, respectively. Ki67 level exceeding 10% (p= 0.048) and absence of surgical resection (p= 0.003) were significantly associated with worse overall survival (OS). Conclusion: Surgical treatment was currently the primary method for treating Th-NETs, and postoperative adjuvant therapy was an essential consideration for specific patient cohorts. Despite widespread positive MGMT expression, TMZ-based chemotherapy showed promise. Some potential prognostic biomarkers such as NLR and NSE need more attention.
背景：胸腺神经内分泌肿瘤（Th-NETs）是一种罕见且侵袭性强的疾病，目前关于其预后预测的研究较为缺乏。本研究旨在评估预后标志物及以替莫唑胺（TMZ）为基础的化疗对Th-NETs患者生存的影响。方法：我们回顾性分析了2013年至2023年间在本机构诊断为Th-NETs患者的病历资料。收集的临床病理数据包括肿瘤病理分级、分期、血清神经元特异性烯醇化酶（NSE）和胃泌素释放肽前体浓度、炎症因子水平以及氧6-甲基鸟嘌呤-DNA甲基转移酶（MGMT）的表达情况。同时记录了治疗细节（如手术和化疗）及生存结局。结果：在排除信息不完整的患者后，共纳入32例患者。其中19例接受以TMZ为基础化疗的患者中位无进展生存期（PFS）为12.5个月（95%CI，8-16个月）。21例以手术作为主要治疗方式的患者中位无病生存期（DFS）为51.0个月。炎症因子中性粒细胞与淋巴细胞比值（NLR）是术后患者DFS及TMZ治疗患者PFS的独立预后指标。总体3年、5年和10年生存率分别为86.6%、69.5%和33.8%。Ki67水平超过10%（p=0.048）和未行手术切除（p=0.003）与较差的总生存期（OS）显著相关。结论：手术治疗是目前Th-NETs的主要治疗手段，术后辅助治疗是特定患者群体需重点考虑的环节。尽管MGMT普遍呈阳性表达，以TMZ为基础的化疗仍显示出应用前景。NLR、NSE等潜在预后生物标志物值得更多关注。
肿瘤(癌症)患者之家