[重症肌无力合并胸腺瘤的治疗：20例报告]

[The treatment of thymoma with myasthenia gravis: report of 20 cases].

作者信息

Kurashige M, Kawai K, Suzuki M, Kurita M, Sumiyama Y

机构信息

Third Department of Surgery, Toho University School of Medicine, Tokyo, Japan.

出版信息

Kyobu Geka. 1993 Jan;46(1):61-8.

PMID:8418362

Abstract

Sixty-eight patients with myasthenia gravis underwent thymic surgery in our department. Among of 68 cases, twenty patients with thymoma were followed and their prognosis were investigated. Sixteen cases received a extended thymectomy with thymomectomy, six cases received local irradiation, and 16 cases received a chemotherapy. Among of 16 cases, 13 cases received corticosteroid only, and 3 cases received CHOP (CPA+ADM+VCR+PSL). Survival rates for thymoma of 20 cases were 94.7%, 88.9%, 78.6%, and 54.5% at 1, 3, 5 and 7 years, respectively. Survival rates for thymoma at 5 years were 83.3%, 50.0%, 100%, and 100% in stage I (complete encapsulation of 8), II (invasion into pericapsular fatty tissue of 7), III (invasion into surrounding organ of 3), and IV a (pleural dissemination of 2), respectively. Survival rate for extended thymectomy with thymomectomy of 16 cases was 81.8% at 5 years. Among of 18 total resection cases of thymoma, a recurrence occurred (5.6%). Causes of 6 death after surgery were crises of myasthenia gravis (3), other diseases (2), and recurrence of thymoma (1).

摘要

68例重症肌无力患者在我科接受了胸腺手术。在这68例患者中，对20例胸腺瘤患者进行了随访并调查其预后。16例患者接受了扩大胸腺切除术加胸腺瘤切除术，6例接受局部放疗，16例接受化疗。在16例化疗患者中，13例仅接受皮质类固醇治疗，3例接受CHOP方案（环磷酰胺+阿霉素+长春新碱+泼尼松）治疗。20例胸腺瘤患者1年、3年、5年和7年的生存率分别为94.7%、88.9%、78.6%和54.5%。I期（8例完整包膜）、II期（7例侵犯包膜周围脂肪组织）、III期（3例侵犯周围器官）和IV a期（2例胸膜播散）胸腺瘤患者5年生存率分别为83.3%、50.0%、100%和100%。16例扩大胸腺切除术加胸腺瘤切除术患者5年生存率为81.8%。在18例胸腺瘤全切除病例中，有1例复发（5.6%）。术后6例死亡原因分别为重症肌无力危象（3例）、其他疾病（2例）和胸腺瘤复发（1例）。