49例胸腺瘤外科治疗及临床病理特征回顾

Clinical pathological characteristics and surgical treatment for 49 cases of thymoma

目的总结胸腺瘤的外科治疗经验及其病理特征。方法回顾性分析2002年1月至2011年10月手术治疗的胸腺瘤49例,对切除肿瘤的大小、是否合并重症肌无力(MG)、组织学分类在临床分期中的分布,并分析其意义。结果 49例手术16例采用胸腔镜手术,全组完全切除率为91.84%,临床Ⅰ、Ⅱ期完全切除率100.00%,Ⅲ期60.00%。全组无手术死亡。88.89%的A型和AB型分布在Ⅰ期,而80.00%的B3型和C型分布在Ⅲ期,伴MG的胸腺瘤61.54%分布在Ⅰ期。Ⅰ期伴MG胸腺瘤的最大直径显著小于无MG胸腺瘤,各临床分期肿瘤大小差异无统计学意义。结论胸腺瘤组织学分型、有无MG与临床分期有密切关系,肿瘤的大小与临床分期差异无统计学意义。

Objective To explore the clinical characteristics and outcome of thymoma after operation. Methods Data of 49 pa tients with thymoma underwent surgical treatment from Jan 2002 to Oct 2011 in our department was retrospectively analyzed. The tumor sizes,combined myasthenia gravis（MG）, as well as the histological classification between the different clinical stages were compared. Results Among these 49 cases,16 underwent thymectomy by VATS. The complete resection（CR） ratio was 91.84%. All patients in stage Ⅰ and Ⅱ obtained CR. Only 60.00% of patients in stage Ⅲ acquired CR. No postoperative death was ob served. 88.89% of A and AB type of thymoma distributed in the stage Ⅰ ,and 80.00% of Ba and C type of thymoma in the stage Ⅲ. Meanwhile,61.54% of patients with MG were in the stage Ⅰ . Conclusion The histological classification and combined MG were closed related with the Masaoka stage,and there was no significant difference of tumor size in various Masaoka stages.