重症肌无力合并胸腺瘤的CT及血清相关抗体

Thymus CT Scan and Thymoma Associated Antibodies in Myasthenia Gravis with Thymoma

目的探讨胸腺瘤相关抗体与CT检查对重症肌无力合并胸腺瘤诊断的临床意义。方法对32例胸腺CT检查异常并行手术治疗的重症肌无力患者的血清titin和兰尼定碱受体(RyR)抗体进行检测,并与术后病理诊断进行比较。结果32例患者经术后病理检查,21例为胸腺瘤、11例为胸腺增生;CT检查敏感性为90·5%;CT结合胸腺瘤相关抗体检查对胸腺瘤诊断的特异性为100%。结论血清胸腺瘤相关抗体检查有助于胸腺瘤及胸腺增生的鉴别诊断,如与CT相结合,能提高其诊断胸腺瘤敏感性。

Objective To investigate the clinical significance receptor （RyR） antibody level and thymus CT scan in the diagnosis of the serum anti-titin, anti-ryanodine of myasthenia gravis with thymoma. Methods Totally 32 patients with myasthenia gravis who had received thymectomy were included in the study. Abnormalities were shown under CT scan of thymus in all these patients. The relationships were studied among the pathological diagnosis, CT findings, and serum level of thymoma associated antibodies： anti-titin and anti- RyR antibodies. Results The pathological diagnosis of thymoma was made in 21 patients and thymus hyperplasia in 1 lpatients after operation. The sensitivity of CT scan in the diagnosis of thymomas was 90. 5%, the specificity of serum thymoma associated antibodies in the diagnosis of thymoma was 100%. Conclusion The thymoma-associated antibodies test is helpful in the differential diagnosis of thymomas and thymus hyperplasia; when combined with CT scan, it may achieve high sensitivity in the diagnosis of the thymoma.