26例胸腺瘤的外科治疗

SURGICAL TREATMENT OF THYMIC MASS ANALYSIS OF 26 CASES

首都医院自1961~1977年手术治疗胸腺肿物病人26例,其中24例为实质性胸腺瘤,1例胸腺囊肿,1例胸腺增生,26例中11例属临床病理恶性(42%)。1/3病人伴有重症肌无力,约1/6病人伴有白血病、结节性红斑、米尼尔氏综合症和妊娠。11例恶性瘤中5例未能切除,2例系姑息性切除,4例完全切除。病理检查发现肿瘤大小与性质良恶间,细胞形态与重症肌无力问均无何特殊联系。切除后5年生存率75%,10年生存率60%。肿瘤性质良恶与重症肌无力的严重程度对预后有重要影响。

26 patients with thymic masses were operated upon from 1961 to 1977 in Capital Hospital.There were 24 cases of thymoma.Ⅰeyst andⅠhypertrophy,Ⅱcases(42%)were clinically-pathologically malignant,1/3 of the patients had mysthenia gravis,and in 1/6 cases leukemia,erythema nodosa.Meniere’s syndrome or pregnancy co-existed.Excision was done in 21 patients.Among the 11 malignant thymomas exploratory thoracotomy and biopsy were done in 5 pstients,complete extirpation was perfomed in 4 patients,and in 2 patients only palliative excision was possible.Pathological examination showed no specific correlation between the tumor size and malignancy,nor do the histological characteristics with myasthenia gravis,but lymphocytetype thymoma seemed to have a better prognosis.The over all 5-year survival rate for thymoma was 75%,and 10-year survival rate,60%.Factors influening prognosis were tumor malignancy and severity of the associated myasthenia gravis.