胸腺瘤与自身免疫性疾病的关系

Review on thymoma and thymoma-associated autoimmune diseases

胸腺瘤是起源于胸腺上皮细胞、位于前上纵隔的肿瘤,它的产生可导致胸腺免疫耐受缺失,从而导致多种自身免疫性疾病,包括重症肌无力、单纯红细胞再生障碍性贫血、系统性红斑狼疮和副肿瘤性天疱疮等。近年来对其合并自身免疫性疾病的机制主要提出了不成熟T细胞学说、肿瘤-基因学说、细胞免疫和体液免疫联合机制学说。临床经验提示,胸腺瘤切除对改善部分患者自身免疫性疾病的症状有重要作用。

Thymic carcinomas are tumors of the anterior mediastinum derived from the epithelial cells of the thymus gland. Malignancies linked to thymoma lead to the loss of self-tolerance leading to autoimmune diseases, including myasthenia gravis, pure red cell aplastic anemia, systemic lupus erythematosus and pemphigus etc. In recent years, three main mechanisms have been proposed to elucidate these interactions, such as immature T cell theory, tumor-gene theory and the combination mechanism of cellular and humoral immunity. In fact, the resection of the thymoma is beneficial to many patients of thymoma related autoimmune diseases.