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重症肌无力作为胸腺瘤患者的预后标志物。

Myasthenia gravis as a prognostic marker in patients with thymoma.

作者信息

Cacho-Díaz Bernardo, Salmerón-Moreno Karen, Lorenzana-Mendoza Nydia A, Texcocano Julia, Arrieta Oscar

机构信息

Neuroscience Unit, Instituto Nacional de Cancerología, México City, México.

Thoracic Oncology Unit, Instituto Nacional de Cancerología, México City, México.

出版信息

J Thorac Dis. 2018 May;10(5):2842-2848. doi: 10.21037/jtd.2018.04.95.

Abstract

BACKGROUND

Thymoma is the most common mediastinal tumor, representing <1% of all cancers. It is usually associated with paraneoplastic disorders, mainly myasthenia gravis (MG). The aim of the present study was to describe patients with thymoma and the differences between those with MG and those without it.

METHODS

A retrospective 10-year database of the patients with thymoma treated at a single cancer referral hospital (National Institute of Cancer, Mexico City), was analyzed.

RESULTS

Sixty-four files from patients with thymoma were analyzed, 18 of them had MG. The symptoms that occurred most frequently in patients with MG were ptosis, diplopia, appendicular weakness, dysphonia and dysphagia. The most frequent Myasthenia Gravis Foundation of America (MGFA) stage was IIIb followed by stage I. Almost all the patients with MG had positive Acetylcholine Receptor antibodies (P<0.001), with not specified antibodies in four patients. The median overall survival showed a trend to be higher among the patients with MG, but there were no significant differences.

CONCLUSIONS

In patients with thymoma MG manifests with different clinical and autoimmune traits, but not survival differences. A larger multi-centric study should be encouraged to evaluate the prognostic implications of having MG in patients with thymoma.

摘要

背景

胸腺瘤是最常见的纵隔肿瘤,占所有癌症的比例不到1%。它通常与副肿瘤性疾病相关,主要是重症肌无力(MG)。本研究的目的是描述胸腺瘤患者以及伴有和不伴有MG的患者之间的差异。

方法

对一家癌症转诊医院(墨西哥城国家癌症研究所)治疗的胸腺瘤患者的10年回顾性数据库进行分析。

结果

分析了64例胸腺瘤患者的病历,其中18例患有MG。MG患者最常出现的症状是上睑下垂、复视、肢体无力、发音困难和吞咽困难。美国重症肌无力基金会(MGFA)最常见的分期是IIIb期,其次是I期。几乎所有MG患者的乙酰胆碱受体抗体均为阳性(P<0.001),4例患者抗体未明确。中位总生存期在MG患者中呈较高趋势,但无显著差异。

结论

在胸腺瘤患者中,MG表现出不同的临床和自身免疫特征,但生存期无差异。应鼓励开展更大规模的多中心研究,以评估MG对胸腺瘤患者预后的影响。

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