Objective: We investigated the clinical value of a novel circulating tumor cell (CTC) detection method-subtraction enrichment combined with immunostaining and fluorescence in situ hybridization (SEiFISH)-in ovarian cancer (OC). This study evaluated the diagnostic and prognostic significance of chromosome 8 aneuploidy in CTCs and circulating tumor endothelial cells (CTECs) for preoperative diagnosis, treatment efficacy assessment, and recurrence monitoring. Methods: A total of 331 patients were enrolled, including 56 with newly diagnosed primary OC, 265 with benign ovarian tumors, and 10 with borderline tumors. Peripheral blood CTCs and CTECs were detected using SEiFISH; their quantity and ploidy characteristics were analyzed in relation to clinical indicators. To assess dynamic CTC changes during disease progression and treatment response, 72 patients were followed longitudinally, of whom 19 experienced recurrence. Results: The CTC detection rate in OC patients was 92.9%, with significantly higher counts than that in the benign tumor group (median 5 vs. 2). Receiver operating characteristic analysis demonstrated good diagnostic performance for total CTCs [area under the curve (AUC)=0.699], with triploid CTCs achieving the highest efficacy (AUC=0.792), surpassing carbohydrate antigen 125 (CA125) (AUC=0.702). Postoperative follow-up showed that 70% of patients exhibited concurrent decreases in CTCs and CA125 levels, indicating disease improvement. In 30% of patients, CTC levels did not correlate with changes in CA125 levels. Individual case evidence suggests that CTC alterations may serve as an early indicator of recurrence or metastasis. Among the 19 recurrent cases, 73.7% showed elevated CTCs at recurrence that decreased following treatment. In four patients, CTCs reflected disease progression earlier than CA125, indicating higher sensitivity for recurrence monitoring. Conclusions: CTCs with chromosome 8 aneuploidy demonstrate significant clinical value in the preoperative diagnosis, treatment efficacy evaluation, and recurrence monitoring of OC. Dynamic CTC changes may serve as a more sensitive indicator than CA125 for disease surveillance, supporting the translational potential of CTC-based biomarkers in OC.

Near-infrared fluorescence (NIRF) imaging is an excellent choice for image-guided surgery due to its simple operation and non-invasiveness. Developing tumor-specific fluorescent molecular probes is key to fluorescence imaging-guided surgery. EGFR (epidermal growth factor receptor) is closely related to the proliferation and growth of tumor cells and is highly expressed in epithelial ovarian cancer (EOC). The study aims to construct a NIR fluorescent molecular probe using cetuximab (an EGFR monoclonal antibody) and investigate its feasibility for targeting EOC in vivo through fluorescence imaging. We determined the expression of EGFR in EOC. NIR fluorescent molecular probe with cetuximab (cetuximab-Cy7) was chemically engineered and identified. The subcutaneous xenografted tumor model of EOC was induced using SKOV3-Luc cell line with positive expression of EGFR. Cetuximab-Cy7 was used for in vivo fluorescence imaging, and phosphate-buffered saline, free Cy7 dye and mouse isotype immunoglobulin G-Cy7 were used as controls. NIRF imaging system was performed to study the distribution and targeting of the probes. Tumors were imaged in situ and ex vivo, and fluorescent intensity was quantified. Resected specimens were analyzed to confirm diagnosis, and immunohistochemical (IHC) staining was used to identify EGFR expression. EGFR expression was increased in EOC tissues than fallopian tube tissues. The high expression of EGFR was significantly correlated with well-differentiation, residual lesions ≤ 1 cm, no recurrence and increased survival. NIRF imaging showed that the cetuximab-Cy7 enabled detection of tumor lesions in EOC-bearing mice with the optimal dose of 30 µg. The suitable imaging time window may be 24–96 h post-injection. Ex vivo fluorescence imaging indicated that fluorescent signal was mainly detected in the tumor and the lung. IHC results confirmed that xenografts were EGFR positive. Cetuximab-Cy7 can specifically target the tumors of EOC xenografted nude mice. This research lays the foundation for future studies on EOC surgery navigation.

Objective To analyze the effects of aryl organophosphate esters(aryl-OPEs)on female reproductive health.Methods Urine samples from 571 women with infertility who sought in vitro fertilization-embryo transfer treatment at the Reproductive Center of Peking University People's Hospital from January 2018 to January 2021 were tested for concentrations of four aryl-OPE metabolites:diphenyl phosphate(DPHP),4-hydroxyphenyl diphenyl phosphate(4-OH-TPHP),2-ethyl-5-hydroxyhexyl diphenyl phosphate(5-OH-EHDPP),and 4-(hydroxymethyl)phenyl di-p-tolyl phosphate(4-OH-MDTP).Continuous independent variable data were converted into categorical variables,divided into four levels(Q1,Q2,Q3,Q4)using the 25th,50th,and 75th percentiles as cut-off points.After reassigning values to the independent variables in each group,they were incorporated into the regression model as continuous variables for trend testing.Using multivariable linear mixed models,the correlations between aryl-OPE metabolite concentrations and reproductive hormones[estradiol(E2),progesterone(P),testosterone(T),follicle-stimulating hormone(FSH),luteinizing hormone(LH),and prolactin(PRL)]and infertility causes were assessed by adjusting for relevant covariates(age,BMI,smoking status,education level,infertility reason,and primary infertility diagnosis).Results The detection rates of the four aryl-OPE metabolites were all＞80％.The results of the multivariable linear regression model showed that the concentrations of 4-OH-MDTP and 5-OH-EHDPP in urine were associated with decreased E2 levels(P＜0.05).The E2 level in the 4-OH-MDTP Q3 group was significantly lower by 20.59％compared to the Q1 group,and in the 5-OH-EHDPP Q4 group,it decreased by 34.52％compared to the Q1 group.The exposure concentrations of 4-OH-TPHP and DPHP showed a significant positive correlation with progesterone levels(P＜0.05).The progesterone level in the 4-OH-TPHP Q3 group was significantly increased by 42.42％compared to the Q1 group,and in the DPHP Q4 group,it was significantly increased by 32.85％compared to the Q1 group.In the analysis of infertility causes,the concentrations of 4-OH-TPHP and 4-OH-MDTP in patients with polycystic ovary syndrome(PCOS)and endometriosis were significantly higher than those in women undergoing in vitro fertilization due to male factors.Moreover,the risk of PCOS and endometriosis increased in the 4-OH-TPHP and 4-OH-MDTP Q2-Q4 groups compared to the Q1 group.Conclusion Aryl-OPEs can interfere with estrogen and progesterone levels in women.The parent compounds and metabolites may be associated with the occurrence of PCOS and endometriosis and could be one of the causes of infertility.

目的:评估在卵巢癌患者盆腔淋巴结清扫区域使用可吸收防粘连纤维膜能否降低淋巴结切除术后淋巴囊肿的发生率.方法:回顾分析2018年10月至2020年12月于北京大学人民医院及山东省青岛市即墨人民医院初次手术治疗的109例卵巢癌患者的资料,术中使用可吸收防粘连纤维膜的卵巢癌患者85例(干预组),未进行防粘连处理的卵巢癌患者24例(对照组).患者均进行全面分期手术或肿瘤细胞减灭术,同时行盆腔淋巴结及腹主动脉旁淋巴结切除术.术后通过临床症状、影像学检查(B超、CT扫描或MRI)诊断淋巴囊肿.比较两组患者的淋巴囊肿发生率,伴有症状的淋巴囊肿发生率,以及淋巴囊肿直径.结果:术后发生淋巴囊肿54例(49.54％),伴有症状(压痛、感染、下肢水肿)的淋巴囊肿4例(3.67％).干预组中36例(42.35％)患者术后出现淋巴囊肿,对照组18例(75.00％)患者术后出现淋巴囊肿(P=0.005).干预组中1例患者(1.18％)发生淋巴囊肿感染,对照组有3例(12.5％)为伴有症状的淋巴囊肿(P=0.033).干预组和对照组的淋巴囊肿直径比较,差异无统计学意义[(6.02±2.90)cm vs(6.54±3.05)cm,P=0.551],干预组中出现直径>5 cm淋巴囊肿发生率显著低于对照组(25.88％vs 58.33％,P=0.003).结论:卵巢癌术后淋巴囊肿形成仍是术后较常见的并发症.可吸收防粘连纤维膜可有效减少卵巢癌术后淋巴囊肿形成及症状性淋巴囊肿的发生.

ObjectiveThe goal of this study was to find the risk factors for major intraoperative blood loss (MBL) of primary debulking surgery (PDS) for ovarian cancer.MethodsPatients with ovarian cancer who underwent PDS in our hospital, from 2010 to 2017, were enrolled. The association between risk factors and MBL was modeled with the use of logistic regression. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive value of the logistic regression model.ResultsA total of 346 patients met the inclusion criteria. There were 150 patients with MBL. Tumor stage 3/4 (P ​< ​0.001), American Society of Anesthesiologists (ASA) score ≥3 (P ​= ​0.044), ascites volume ≥500 ​ml ​(P ​= ​0.002), radical or ultra-radical surgery (P ​= ​0.002), and diabetes (P ​= ​0.035) were independent risk factors for MBL in patients with ovarian cancer. The logistic regression combined model of these five factors is more reliable in the prediction of MBL with an area under the ROC curve of 0.729 than the tumor stage (ROC curve ​= ​0.645) and surgical complexity (ROC curve ​= ​0.568).ConclusionIn patients with ovarian cancer, five risk factors for major intraoperative bleeding were identified. Planned surgical procedures and preoperative risk factors can be used to predict perioperative blood requirements.

Ovarian cancer is a leading cause of death among gynecological malignancies, and novel therapies are urgently needed. Here we report preliminary findings on the potential safety and efficacy of 6B11-OCIK, an adoptive cell therapy of autologous T cells induced by the humanized anti-idiotypic antibody 6B11 minibody plus dendritic cells and cytokines, against platinum-resistant recurrent or refractory ovarian cancer in three patients. We found that 6B11-OCIK treatment was safe and well tolerated after five cycles of intravenous infusion with an initial dose of 1–2×109 cells and a dose-climbing strategy. Hemoglobin, platelets, white cell count, creatinine or liver enzyme values, coagulation function, kidney and heart function were not significantly affected over the duration of therapy. Two of the three enrolled patients showed potentially drug-related grade 1 and 2 weakness, and no other adverse events were observed. Of the three enrolled patients, one had stable disease and two showed disease progression. The patient with favorable clinical efficacy had better immune response as measured by 6B11-OCIK proliferation capacity, activation ability of CD3+CD8+ tumor-specific cytotoxic T lymphocytes and CD3+CD56+ cytokine-induced killer cells, and tumor cell killing efficiency. Changes in circulating tumor cells after treatment were consistent with serum level CA125 in the patient with stable disease (both decreased), while differences were observed in the two patients with disease progression (increased CA125 in both and decreased CTC in the patient with better immune response), suggesting that variation of circulating tumor cells was more consistent with immune response and reflected efficacy directly. This preliminary study suggested that autologous 6B11-OCIK treatment was safe and had potential clinical efficacy against ovarian cancer. Patients with better immune response had more favorable efficacy. In addition to imaging, CA125 and immunophenotypes, CTC monitoring may represent a potential indicator of immunotherapy response.

目的 探讨FIGOI期子宫内膜样癌前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)的学习曲线.方法 选取2015年10月至2018年6月本院诊断I期子宫内膜样癌并进行分期手术+SLNB的60例患者.按照进行SLNB手术时间分为A组(2015年10月至2016年12月)、B组.(2016年12月至2018年2月)及C组(2018年2月至2018年6月),每组20例.比较各组SLNB手术时间、检出率、灵敏度等.结果 C组SLNB手术时间明显短于A组和B组(P＜0.05).60例患者中,成功显影SLN共51例(85％),双侧SLN 43例(71.67％),主要为髂外淋巴结47例(78.33％)、闭孔淋巴结31例(51.67％).A组、B组和C组总检出率分别为70％(14/20)、90％(18/20)和95％(19/20),三组比较,差异有统计学意义(P=0.021);A组SLNB灵敏度为50％,阴性预测值为92.30％,B组和C组均为100％.结论 SLNB存在学习曲线;经过40例SLNB后可达到较为熟练、准确的程度.

目的 分析尼可地尔对老年急性心肌梗死(AMI)后心搏骤停患者预后的影响.方法 回顾性分析2019年2月至2020年2月完成治疗和随访的100例AMI后心搏骤停老年患者的临床资料,根据不同治疗方式分为对照组(给予常规治疗,47例)及观察组(在对照组基础上联合尼可地尔治疗,53例).治疗1个月,对比两组心肌梗死血管再通率;于治疗前、治疗后1个月对比两组心肌损伤标志物肌钙蛋白(cTn)I水平;于治疗前、治疗后1个月对比两组心功能〔左室射血分数(LVEF)、左室舒张末期内径(LVEDD)〕;所有患者获得1年随访,对比两组出院及1年存活率;治疗期间,记录并发症发生情况.结果 两组出院存活率差异无统计学意义(P>0.05);治疗后,观察组血管再通率、1年存活率、LVEF水平均高于对照组,且并发症发生率、cTnI水平、LVEDD值均低于对照组,差异有统计学意义(P<0.05).结论 老年AMI后心搏骤停患者经尼可地尔治疗,不仅可提高血管再通率、改善心功能、减轻心肌损伤,也可提高短期存活率,并发症发生情况减少,利于促进患者良性预后.

目的 观察放疗对子宫恶性肿瘤术后患者阴道微生态的影响.方法 选取2018年12月至2019年9月在北京大学人民医院放疗科行术后放疗的子宫内膜癌与宫颈癌患者共48例,由于其中18例患者根据期别等采取的放疗方式为单纯腔内近距离放疗,在治疗期间即采取冲洗措施,故最终接受观察放疗对阴道微生态影响的患者为30例.30例患者在放疗开始前、放疗3、5周后留取阴道分泌物,观察放疗对子宫恶性肿瘤术后患者阴道微生态的影响.结果 与同年龄段正常体检女性相比,子宫恶性肿瘤术后患者阴道菌群密集度、多样性、优势菌、Nugent评分、pH值、H2O2、微生态结果等指标差异均有统计学意义(P＜0.05).与同期同年龄段无需放疗的子宫恶性肿瘤术后患者相比,需放疗子宫恶性肿瘤术后患者的上述指标差异均无统计学意义(P＞0.05).放疗前后部分指标差异均无统计学意义(P＞0.05),白细胞/油镜＜10的患者占比呈下降趋势(P＜0.05).结论 子宫恶性肿瘤术后的患者阴道微生态失调的发生率明显增高.术后需要放疗与无需放疗的患者阴道微生态检测结果无明显差异.放疗后产生炎症的患者增多,但未观察到放疗对阴道菌群产生明显影响.

目的 分析老年心力衰竭患者心电异常活动状况及其与左心室心肌收缩功能的关系.方法 回顾性分析2019年2月至2020年2月完成治疗与随访的150例老年心力衰竭患者病历资料纳入心力衰竭组,同期收治老年非心力衰竭患者146例为对照组,使用心脏彩超检查仪检测心力衰竭组左室射血分数(LVEF),评估左室心肌收缩功能;使用心电图仪检测患者心电图指标(QTc间期、QRS时限值、QRS电压值);分析老年心力衰竭患者左心室心肌收缩功能与心电异常活动程度的相关性.结果 心力衰竭组LVEF及QRS电压值小于对照组,且QTc间期及QRS时限值大于对照组,差异有统计学意义(P<0.001);150例老年心力衰竭患者,左心室心肌收缩功能轻度障碍65例,中度障碍53例,重度障碍32例;重度组QTc间期及QRS时限值最高,中度组次之,后为轻度组,对照组最低,组间比较差异有统计学意义(P<0.05);QRS电压值重度组最低,中度组次之,后为轻度组,对照组最高,差异有统计学意义(P<0.05);采用双变量Pearson直线相关性分析发现,老年心力衰竭患者LVEF水平与QTc间期及QRS时限值呈负相关(P<0.001);与QRS电压值呈正相关(P<0.001).结论 老年心力衰竭患者存在不同程度左心室心肌收缩功能障碍,可能与心电异常活动相关,随着患者心电异常活动程度加重,左心室心肌收缩功能障碍加重,临床可通过早期持续监测老年心力衰竭患者心电指标,观察心电异常活动程度,以评估其左室收缩功能,指导早期防治.

Objective:To investigate the clinical value of brain natriuretic peptide (BNP) in the diagnosis of heart failure.Methods:A total of 71 cases of patients with heart failure were selected as observation group.In the same period,71 healthy subjects were selected as the control group.The levels of BNP,left ventricular ejection fraction (LVEF),BNP grade with different cardiac function and positive rate were compared between the two groups.Results:The LVEF in the observation group was significantly lower than that in the control group,and the levels of BNP was higher than that in the control group,the difference was statistically significant (P ＜0.05).The positive rate of grade Ⅰ was 53.33％,the positive rate of grade Ⅱ was 76.47％,the positive rate of grade Ⅲ was 95.00％,the positive rate of grade Ⅳ was 100.00％.The level of BNP in patients with grade Ⅳ cardiac function was significantly higher than that in grade Ⅰ,Ⅱ and Ⅲ patients,the difference was statistically significant (t =36.535,24.466,19.305,P ＜0.05).The level of BNP in patients with heart function grade Ⅲ was higher than that of patients with grade Ⅰ,and the difference was statistically significant (t =2.732,P ＜ 0.05).However,there was no significant difference between the level of BNP in the patients with cardiac function grade Ⅱ with these in the grade Ⅰ and Ⅲ.Conclusion:BNP detection has a good effect in the diagnosis of heart failure,which is helpful for early diagnosis,and the more serious the heart failure is,the higher the positive detection rate and detection value are.

Objective To evaluate the associativity between renal dysfunction and long-term mortality of cardiovascular disease in patients with acute decompensated heart failure (ADHF) treated by intensive care unit (ICU).Methods A total of 428 patients with ADHF were selected.The patients were divided into worsening renal function group (WRF group, n=168) and no worsening renal function group (non-WRF group, n=260) according to whether WRF occurred during ICU treatment.The demographic data, clinical data and laboratory data and cumulative survival were compared between the two groups.The patients were followed up, and the Cox proportional hazards model was used to assess the relationship between WRF and all-cause mortality or cardiovascular mortality.Results 168 (39.2%) patients of the 428 patients had WRF.The cardiovascular mortality (19.6% vs.8.1%, P<0.001) and all-cause mortality (28.6% vs.15.4%, P<0.001) in the WRF group were significantly higher than those in the non-WRF group.Multivariate Cox proportional hazards model showed that age, serum BNP levels were significantly associated with all-cause death (age: HR=1.125, 95%CI 1.042~1.236, P=0.006;BNP: HR=1.005, 95%CI 1.002~1.011, P=0.026) and cardiovascular death (age: HR=1.132, 95%CI 1.036~1.263, P=0.011;BNP: HR=1.008, 95%CI 1.002~1.035, P=0.030).Conclusion The worsening renal function is associated with cardiovascular death in patients with acute decompensated heart failure.WRF may be one of the criteria for determining follow-up after discharge from patients with acute decompensated heart failure.

目的:探讨用阿托伐他汀钙片治疗慢性心衰的临床效果.方法:对近年来我院收治的96例慢性心衰患者的临床资料进行回顾性研究.我院随机将这些患者分为甲组和乙组,每组各有48例患者.我院对甲组患者进行常规治疗,对乙组患者在进行常规治疗的基础上使用阿托伐他汀钙片进行治疗,然后比较两组患者治疗的效果.结果:两组患者在接受治疗后,乙组患者的LVEDd、LVESD以及LVEF等指标均明显优于甲组患者,差异显著(P<0.05),具有统计学意义.乙组患者NF-α、IL-6以及BNP的水平均明显优于甲组患者,差异显著(P<0.05),具有统计学意义.结论:用阿托伐他汀钙片治疗慢性心衰的临床效果显著,可有效地改善患者的心功能.

目的 探讨氯吡格雷治疗与急性冠状动脉综合征(acute coronary syndrome,ACS)患者主要心血管不良事件增加与早期支架内血栓形成相关性.方法 纳入1286例ACS患者,将患者分为氯吡格雷入院前长期治疗组(氯吡格雷组,n=162)与未接受氯吡格雷治疗组(非氯吡格雷组,n=1124).比较2组患者住院期间及出院后30d主要不良心血管事件发生率,包括死亡、ACS复发、脑卒中发病、支架内血栓形成等.采用Logistic回归分析患者主要心血管不良事件发生的相关因素.结果 氯吡格雷组合并症发生率、心脑血管病史与既往血运重建治疗史患者比例显著高于非氯吡格雷组(均P ＜0.001);氯吡格雷组患者住院期间支架内血栓形成、急性肾衰竭和充血性心力衰竭发病率显著高于非氯吡格雷组(均P＜0.05).出院30d氯吡格雷组患者支架内血栓形成发病率、ACS复发率均显著高于非氯吡格雷组(均P ＜0.05),多元Logistic回归分析表明长期氯吡格雷治疗是患者发生主要不良心血管事件的独立危险因素(OR=1.36,95％ CI:1.03-1.83,P=0.045),也是出院30 d支架内血栓形成的独立危险因素(OR =2.71,95％ CI:1.39-5.76,P =0.02).结论 氯吡格雷治疗是ACS患者主要心血管不良事件,是支架内血栓形成的高危因素.

Objective To evaluate the clinical efficacy of meglumine cyclic adenylate in treatment of patients with chronic congestive heart failure.Methods Forty patients with congestive heart failure admitted in this hospital during August 2008 to February 2009 were randomly allocated into two groups,each with 20 cases.Patients in control group were treated with digitalis,diuretics,ACEI agents etc.On this basis,patients in treatment group were additionally added with meglumine cyclic adenylate.Observations on improvement of clinical symptoms,cardiac function etc were carried out at two weeks after treatment as indicators for determining the efficacy of treatment in patients of these two groups.Results Five of 20 patients with markedly effective,14 cases with effective and failure in 1 case were seen in treatment group after treatment with a total effective rate of 95.0%.Two patients with markedly effective,13 with effective and 5 with failure were seen in 20 patients of control group,with a total effective rate of 75.0%.The difference among patients of these two groups was statistically significant(P0.05).Left ventricular ejection fraction of patients in these two groups was improved after treatment,the difference was significant(P0.05),and the improvement in patients of treatment group was much marked in comparison with that of patients in control group after treatment and their difference was statistically significant(P0.05).Conclusion Meglumine cyclic adenylate has good clinical efficacy in treatment of patients with chronic congestive heart failure,and it is worthy to be recommended.

目的讨论三种影像检查对纵隔肿瘤的诊断价值.方法回顾性对比研究三种影像检查方法对纵隔肿瘤的定位、定性诊断进行综合评价.17例单纯作胸部正侧位胸片;46例作胸部平扫和静脉增强扫描;8例作胸部磁共振扫描,其中5例作Gd-DTPA静脉增强;5例作系列的平片CT和MRI胸部检查.全部病例通过三种影像检查评价其定位、定性的诊断精确性.结果17例胸部平片X线结果:前纵隔肿瘤13例,后纵隔肿瘤4例.46例作常规胸部平扫和静脉增强扫描.前纵隔肿瘤29例,中纵隔肿瘤7例,后纵隔肿瘤10例.8例作胸部MRI检查,5例前纵隔肿瘤包括前中纵隔肿瘤4例.5例系列的平片、CT、MRI检查病例,前纵隔肿瘤4例.对随机抽样的76例纵隔肿瘤,根据三种影像学检查方式,CT、MRI对纵隔肿瘤诊断明显优于平片,其定位和定性诊断均有显著性差异(P＜0.05),CT与MRI对纵隔肿瘤的定位、定性诊断无显著性(P＞0.05).MRI对纵隔恶性肿瘤的判断高于CT检查,两者间存在显著性(P＜0.05).结论CT检查对于原发性纵隔肿瘤的定性、定位诊断都有十分有用的价值,MRI检查应为CT定性诊断的必要补充.

目的:评价CT对侵袭性和非侵袭性胸腺瘤的鉴别诊断价值.方法:由两位放射科医师采用双盲法对29例侵袭性胸腺瘤和24例非侵袭性胸腺瘤进行单独评价,分析CT诊断侵袭性或非侵袭性胸腺瘤的可靠性,并与手术病理结果对照.结果:侵袭性胸腺瘤(21例,占72%)较非侵袭性胸腺瘤(7例,占29%)有明显的分叶(P<0.05).侵袭性胸腺瘤囊变率(23例,占79%)较非侵袭性胸腺瘤(6例,占23%)高(P<0.01);侵袭性胸腺瘤增强后较非侵袭性胸腺瘤有明显强化.结论:肿瘤边缘分叶或不规则、囊变或坏死、增强前后CT值相差20HU、纵隔脂肪线消失等CT征象提示侵袭性胸腺瘤.