摘要
背景与目的胸腺瘤常伴发重症肌无力(myasthenia gravis,MG),但是这些患者行胸腺切除的预后与MG的关系尚不明确。本研究旨在探讨影响胸腺瘤合并MG患者预后的因素。方法回顾性分析中国胸腺瘤协作组(Chinese Alliance for Research of Thymoma,ChART)数据库1992年-2012年875例随访20年资料完整的胸腺瘤病例,分析世界卫生组织(World Health Organization,WHO)组织学分型、Masaoka分期、术后辅助治疗与MG及预后的关系。结果胸腺瘤WHO组织学分型与MG有相关性,差异有统计学意义(χ~2=24.908,P<0.001)。MG发生率为22.7%,其中B2型(58/178,32.58%)>B3型(65/239,27.20%)>B1型(27/132,20.45%)>AB型(43/267,16.10%)>A型(6/59,10.17%),Masaoka分期与MG无相关性(χ~2=1.365,P=0.714)。生存分析表明WHO分型、Masaoka分期与预后有关(P<0.05),而是否合并MG(χ~2=0.113,P=0.736)、是否行胸腺扩大切除(χ~2=1.548,P=0.213)、术后辅助放疗(χ~2=0.380,P=0.538)与预后无相关,术后辅助化疗与差的预后相关(χ~2=14.417,P<0.001)。是否行胸腺扩大切除与MG的疗效有相关性(χ~2=24.695,P<0.001)。结论胸腺瘤患者是否合并MG和是否行胸腺扩大切除与预后无相关性,胸腺扩大切除可改善MG患者的疗效。
Background and objective Thymoma is frequently associated with myasthenia gravis（MG）. However, whether MG is a factor for the outcome of patients with thymoma following complete thymectomy remains unknown. The aim of this study is to investigate the effect of thymoma with MG prognostic factors. Methods A retrospective analysis of The Chinese Alliance for Research in Thymomas（Ch ART） database within 1992-2012 complete cases 875 cases, 20 years follow-up data analysis thymic tumor tissue type credits and MG, Masaoka staging and prognosis, postoperative adjuvant therapy and relationship with the prognosis of surgical removal of the way. Results Thymic tumor tissue type credit has correlation with MG, difference was statistically significant（χ~2=24.908, P0.001）. MG： incidence of B2 type（58/178, 32.58%） B3 type（65/239, 27.20%） B1（27/132, 20.45%） AB（43/267, 16.10%） type A, 10.17%（6/59）, Masaoka stage has no correlation with MG（χ~2=0.365, P=1.365）. Survival analysis showed that the WHO classification, Masaoka stage associated with prognosis（P0.05）, and whether the merger MG（χ~2=0.113, P=0.736）, postoperative adjuvant radiotherapy（χ~2=0.380, P=0.538） has nothing to do with the prognosis, postoperative adjuvant chemotherapy is associated with poor prognosis（χ~2=14.417, P0.001）. Whether has nothing to do with the prognosis of the thymus resection（χ~2=1.548, P=1.548）, whether the whole correlated with the curative effect of thymus excision with MG（χ~2=24.695, P0.001）. Conclusion Thymoma patients with MG and extended thymectomy have no correlation with prognosis. Extended thymectomy can improve the effect of MG patients.
出处
《中国肺癌杂志》
CAS
CSCD
北大核心
2018年第1期1-7,共7页
Chinese Journal of Lung Cancer
