Ribet M, Voisin C, Gosselin B, Pruvot F R, Ramon P, Wallaert B, Dambron P
Clinique Chirurgicale Ouest, Centre Hospitalier Régional Universitaire, Lille.
Rev Mal Respir. 1988;5(1):53-60.
One hundred and thirteen cases of lympho-epithelial thymomas were studied retrospectively: 56 were of epithelial type, 20 of lymphocytic type, 30 were mixed and 7 were not defined. Eighty-eight were operated on (20 stages I, 47 stages II, 13 stages III and 8 stages IV). There were 69 primary resections (57 complete and 12 incomplete), followed by radiotherapy in 54 cases and 19 secondary resections after radiotherapy (10 complete and 19 incomplete). Twenty-five patients did not have an operation and were treated with radio- and chemotherapy. After primary resection the actuarial survival at 5 years was 64.07% and at 10 years 50.86%. After a secondary resection it was 43.74% at 5 years. After radiotherapy it was 18.67% at 5 years. In operated cases the prognostic importance of staging was confirmed. The cytological structure was not. In myasthenic cases the secondary respiratory complications worsened the prognosis. Post-operative radiotherapy seems to be justified in all cases, but its effect is not statistically significant when resection was complete. Those operated after radiotherapy only showed a benefit if the resection was complete. The outcome of metastatic disease in TLE has been under-estimated and seems to depend on local control of the tumour. The use of chemotherapy remains to be defined.
对113例淋巴上皮性胸腺瘤进行了回顾性研究：上皮型56例，淋巴细胞型20例，混合型30例，未定型7例。88例行手术治疗（Ⅰ期20例，Ⅱ期47例，Ⅲ期13例，Ⅳ期8例）。69例行初次切除（57例完整切除，12例不完整切除），54例术后接受放疗，19例行放疗后二次切除（10例完整切除，9例不完整切除）。25例未手术，接受放化疗。初次切除后5年精算生存率为64.07%，10年为50.86%。二次切除后5年生存率为43.74%。放疗后5年生存率为18.67%。在手术病例中，分期的预后重要性得到证实，而细胞学结构则不然。在重症肌无力病例中，继发呼吸并发症使预后恶化。术后放疗在所有病例中似乎都是合理的，但切除完整时其效果无统计学意义。仅接受放疗后手术者，只有切除完整才显示出获益。TLE中转移性疾病的结局被低估，似乎取决于肿瘤的局部控制。化疗的应用仍有待确定。
