胸腺瘤病理和免疫学特点及其与临床表现相关性的研究

Study of correalation between the pathological and immunological characteristics of thymoma and its clinical feature

目的:探讨合并重症肌无力(myastheniagravis,MG)的胸腺瘤病理学、免疫学特点,以及胸腺瘤在具备何种条件下有导致MG发生的可能。方法:应用免疫组织化学、RT-PCR和细胞培养等方法分别对45例胸腺瘤组织内神经丝蛋白(neurofilament-M,NF-M)、α-乙酰胆碱受体mRNA(α-AchR mRNA)和淋巴细胞的增殖情况进行检测。结果:不同病理类型的胸腺瘤合并MG的概率、NF-M表达不同,皮质型胸腺瘤的MG发生率明显高于其他组,P=0.035。该类型胸腺瘤NF-M的表达率明显高于其他组,P<0.05,胸腺瘤组织内α-AchR mRNA的表达与正常胸腺和增生胸腺组织差异有统计学意义,P<0.05,同时合并MG的胸腺瘤组织内含有针对α-Ach和NF-M的致敏淋巴细胞。结论:当胸腺瘤具备为皮质型胸腺瘤,有类似乙酰胆碱受体抗原(NF-M)的表达,组织内有预致敏的淋巴细胞发育等条件时,MG的发生概率明显增加。

OBJECTIVE：To study the pathological and immunological characteristics of thymoma and analysis what conditions could lead to myasthenia gravis. METHODS： Fifty-five cases of thymomas were investigated. The expression of NF-M in thymoma was examined by immunohistochemistry, the expression of α-AchR mRNA by RT-PCR, and the proliferation of thymocytes by MTT method. RESULTS： The morbidity of MG in the different types of thymoma was different, so was the NF-M expression rate. The cortical thymoma had a higher morbidity of MG, P=0. 035. And the rate of NF-M positive expression in cortical thymoma was higher than that of the other types, P〈0.05. The expression of α-AchR mRNA in thymoma was different from normal thymus and thymus hyperplasia tissues, P〈0.05. There were sensitive lymphocytes to α-AchR and NF-M in the thymoma with MG tissues. CONCLUSION： Thymoma may lead to increase the morbidity of myasthenia gravis, if thymoma is cortical type and similar to AchR antigen （NF-M） and has the sensitive lymphocytes in tissues.