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胸腺瘤相关免疫性疾病及细胞免疫功能障碍:来自泰国的 87 例研究

Associated immunological disorders and cellular immune dysfunction in thymoma: a study of 87 cases from Thailand.

机构信息

Chulalongkorn University, Bangkok, Thailand.

出版信息

Arch Immunol Ther Exp (Warsz). 2013 Feb;61(1):85-93. doi: 10.1007/s00005-012-0207-9. Epub 2012 Dec 11.

Abstract

Several immune disorders are often associated with thymoma. The aim of this study was to analyze the correlation between clinicopathological features of Thai patients with thymoma and concomitant immune-mediated diseases. Medical records of 87 patients diagnosed with thymoma during a 10-year period were retrospectively reviewed. Peripheral blood T cell subsets along with cytokine responses in 15 thymoma patients and 15 healthy controls were comparatively analyzed. The results demonstrated that thymoma type AB and B2 were the most common types among patients diagnosed with thymoma. The most common presentation was incidentaloma, followed by local chest symptoms and autoimmune diseases. The prevalence of autoimmune diseases, immunodeficiency states, and secondary neoplasms was 34.5, 10.3, and 10.3 %, respectively. Autoimmune diseases were most frequently found in thymoma type B2 and sometimes associated with clinical immunodeficiency, although classic Good's syndrome was rare. Patients with thymoma had significantly lower percentage CD4(+ve) T cells and interferon γ response, but higher percentage regulatory T cells than those in healthy controls. This study indicated that the aberrant immunologic disorders comprising autoimmune diseases, immunodeficiency states, and secondary neoplasms were found in almost 40 % of Thai patients with thymoma and possibly related to defectiva cytokine responses and altered T cell subsets.

摘要

几种免疫紊乱常与胸腺瘤相关。本研究旨在分析泰国胸腺瘤患者伴发免疫介导性疾病的临床病理特征的相关性。回顾性分析了 10 年间诊断为胸腺瘤的 87 例患者的病历。比较了 15 例胸腺瘤患者和 15 例健康对照者外周血 T 细胞亚群和细胞因子反应。结果表明,AB 型和 B2 型胸腺瘤在诊断为胸腺瘤的患者中最为常见。最常见的表现为偶然瘤,其次是局部胸部症状和自身免疫性疾病。自身免疫性疾病、免疫缺陷状态和继发性肿瘤的患病率分别为 34.5%、10.3%和 10.3%。自身免疫性疾病最常发生在 B2 型胸腺瘤中,有时与临床免疫缺陷相关,尽管经典的 Good 综合征很少见。与健康对照组相比,胸腺瘤患者的 CD4(+ve)T 细胞比例和干扰素 γ 反应显著降低,但调节性 T 细胞比例较高。本研究表明,近 40%的泰国胸腺瘤患者存在异常免疫紊乱,包括自身免疫性疾病、免疫缺陷状态和继发性肿瘤,可能与细胞因子反应缺陷和 T 细胞亚群改变有关。

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