摘要
目的 研究M櫣ｌｌｅｒ Hermelink组织发生学分类及其临床意义。方法 76例胸腺瘤采用M櫣ｌｌｅｒ Hermelink分类方法进行分类 ,分析胸腺瘤类型与伴发重症肌无力、浸润性及患者预后关系。结果 髓质型和混合型胸腺瘤大多包膜完整 (72 % ) ,仅少数病例 (2 8% )浸润包膜或周围脂肪组织 ;皮质为主型胸腺瘤中度浸润 ;皮质型胸腺瘤和分化良好胸腺癌浸润性较大 ,56 %浸润周围器官 ,2 0 %浸润包膜或周围脂肪组织 ,仅 2 4 %包膜完整 ;其它类型胸腺癌均浸润周围器官、胸腔内或淋巴转移。皮质型胸腺瘤和分化良好胸腺癌较髓质型和混合型更易伴发重症肌无力 (分别为 92 %和 32 % ,P <0 0 5)。髓质型和混合型患者生存期较皮质型胸腺瘤和分化良好胸腺癌明显长 (5年生存率分别为 87 5%和 54 5% ,P <0 0 5)。结论 胸腺瘤类型与肿瘤浸润、伴发重症肌无力和预后明显相关。
Objective To evaluate the method of thymoma classification by Müller Hermelink and colleagues applying clinical practice. Methods Seventy six cases of thymomas were retrospectively studied the relationship between their subtypes and myathenia gravis,invasiveness and prognosis were analyzed . Results All medullary and mixed thymomas were either completely encapsulated (72%) or invasive through the capsule into mediastinal fat(28%).The predominant cortical thymomas were intermediate degree of invasiveness.Cortical thymomas and well differentiated thymic carcinomas showed more invasive,with 56% invasive into adjacent structures and 20% into mediastinal fat through capsule,only 24% completely encapsulated.Other thymic carcinomas were invasive into adjacent structures,pleural seeding or lymph node metastasis.There was an increased cortical thymomas,well differentiated thymic carcinomas in company with myasthenia gravis.The survival rate was significantly higher for patients with medullary and mixed thymomas than for patients with cortical thymomas and well differentiated thymic carcinomas. Conclusion There was a strong correlation between histologic subtype of thymoma associated myasthenia gravis,as well as prognosis.
出处
《中国神经免疫学和神经病学杂志》
CAS
2000年第2期100-104,共5页
Chinese Journal of Neuroimmunology and Neurology
关键词
胸腺瘤
分类
重症肌无力
预后
thymoma
myathenia gravis
classification
prognosis
