Yuan Dongfeng, Gu Zhitao, Liang Guanghui, Fang Wentao, Li Yin
Department of Thoracic Surgery, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Shanghai Chest Hospital, Affiliated to Shanghai Jiaotong University, Shanghai 200030, China.
Zhongguo Fei Ai Za Zhi. 2018 Jan 20;21(1):1-7. doi: 10.3779/j.issn.1009-3419.2018.01.01.
Thymoma is frequently associated with myasthenia gravis (MG). However, whether MG is a factor for the outcome of patients with thymoma following complete thymectomy remains unknown. The aim of this study is to investigate the effect of thymoma with MG prognostic factors.
A retrospective analysis of The Chinese Alliance for Research in Thymomas (ChART) database within 1992-2012 complete cases 875 cases, 20 years follow-up data analysis thymic tumor tissue type credits and MG, Masaoka staging and prognosis, postoperative adjuvant therapy and relationship with the prognosis of surgical removal of the way.
Thymic tumor tissue type credit has correlation with MG, difference was statistically significant (χ²=24.908, P<0.001). MG: incidence of B2 type (58/178, 32.58%) > B3 type (65/239, 27.20%) > B1 (27/132, 20.45%) > AB (43/267, 16.10%) > type A, 10.17% (6/59), Masaoka stage has no correlation with MG (χ²=0.365, P=1.365). Survival analysis showed that the WHO classification, Masaoka stage associated with prognosis (P<0.05), and whether the merger MG (χ²=0.113, P=0.736), postoperative adjuvant radiotherapy (χ²=0.380, P=0.538) has nothing to do with the prognosis, postoperative adjuvant chemotherapy is associated with poor prognosis (χ²=14.417, P<0.001). Whether has nothing to do with the prognosis of the thymus resection (χ²=1.548, P=1.548), whether the whole correlated with the curative effect of thymus excision with MG (χ²=24.695, P<0.001).
Thymoma patients with MG and extended thymectomy have no correlation with prognosis. Extended thymectomy can improve the effect of MG patients.
胸腺瘤常与重症肌无力(MG)相关。然而,MG是否为完全胸腺切除术后胸腺瘤患者预后的一个因素仍不清楚。本研究的目的是探讨MG对胸腺瘤预后因素的影响。
回顾性分析中国胸腺瘤研究联盟(ChART)数据库1992 - 2012年的875例完整病例,进行20年随访数据分析胸腺瘤组织学分型与MG、Masaoka分期与预后、术后辅助治疗以及手术切除方式与预后的关系。
胸腺瘤组织学分型与MG存在相关性,差异有统计学意义(χ² = 24.908,P < 0.001)。MG:B2型发生率(58/178,32.58%)> B3型(65/239,27.20%)> B1型(27/132,20.45%)> AB型(43/267,16.10%)> A型(6/59,10.17%),Masaoka分期与MG无相关性(χ² = 0.365,P = 1.365)。生存分析显示,WHO分类、Masaoka分期与预后相关(P < 0.05),而是否合并MG(χ² = 0.113,P = 0.736)、术后辅助放疗(χ² = 0.380,P = 0.538)与预后无关,术后辅助化疗与预后不良相关(χ² = 14.417,P < 0.001)。胸腺切除范围与预后无关(χ² = 1.548,P = 1.548),是否完整切除胸腺与MG患者的疗效相关(χ² = 24.695,P < 0.001)。
胸腺瘤合并MG患者扩大胸腺切除术与预后无关。扩大胸腺切除术可改善MG患者的疗效。