胸腺瘤的病理类型与重症肌无力发病的相关性研究

Study on the relationship between pathological types of thymoma and myasthenia gravis

目的探讨胸腺瘤WHO病理分型与重症肌无力(MG)发病的相关性。方法收集2008-01—2018-12在大连大学附属新华医院住院的101例胸腺瘤患者,均行胸腺扩大切除术治疗,对患者的临床及病理资料分析,并定期术后随访。根据2004版WHO胸腺瘤的病理分型,分析胸腺瘤患者的WHO病理分型与MG发病的相关性。结果121例胸腺瘤患者中,病理类型A型30.77%合并MG,AB型30.00%合并MG,B1型56.52%合并MG,B2型72.00%合并MG,B3型56.52%合并MG,C型28.57%合并MG,差异有统计学意义(P<0.05)。胸腺切除术的疗效A型有效率最高,为100%,其次是B1型,有效率92.31%,AB型有效率77.78%,B2型有效率66.67%,B3型有效率46.15%,C型有效率最差(0),差异有统计学意义(P<0.05)。结论胸腺瘤的病理类型与MG具有相关性;B2型胸腺瘤与其他病理分型相比更易合并MG;胸腺瘤病理恶性程度越高,手术切除治疗MG的效果越差。

Objective To investigate the relationship between who pathological classification of thymoma and myasthenia gravis(MG).Methods From January 2008 to December 2018,101 patients with thymoma were treated by thymectomy.The clinical and pathological data of the patients were analyzed and followed up regularly.According to who pathological classification of thymoma in 2004,the relationship between who pathological classification and MG was analyzed.Results In 101 patients with thymoma,A type is 33.33%of them had MG,AB type is 28.00%of them had MG,B1 type is 55.56%of them had MG,B2 type is 68.18%of them had MG,B3 type is 60.00%of them had MG,C type is 25%of them had MG(P<0.05).The effective rate of thymectomy was 100%for type A,85.71%for type AB,100.00%for type B1,66.67%for type B2,50.00%for type B3 and 0 for type C(P<0.05).Conclusion The pathological types of thymoma are correlated with MG.The type B2 and B3 thymoma are more likely to be associated with MG than other types of thymoma.The higher the malignant degree of thymoma,the worse the effect of surgical resection on MG.