胸腺瘤组织学分型与重症肌无力及临床分期关系

目的探讨胸腺瘤最新WHO病理分型与重症肌无力(MG)及临床分期之间的关系。方法回顾分析1980-2004年间74例因胸腺瘤行胸腺切除的患者,运用最新WHO分型标准(1999)对胸腺瘤进行重新分类,并运用统计软件对新的WHO组织学分型与MG的发生率及Masaoka临床分期之间的关系做进一步分析。结果(1)胸腺瘤A型2例,AB型23例,B1型4例,B2型27例,B3型16例,C型2例。其中B2型较AB、B1及B3型易合并MG(P<0.05),A型两例均合并MG,而C型则均未合并MG。(2)临床I期:1例,Ⅱ期:30例,Ⅲ期:38例,Ⅳ期:5例。新的WHO组织学分型与Masaoka分期之间关系密切(P<0.01)。结论新WHO组织学分型与胸腺瘤合并MG的发生率之间有一定关系,同时能反映其临床分期及评价患者的预后。

Histologic Classification of Thymoma and Its Relationship with Myasthenia Gravis and Clinical Stages of the Tumor

Objective: To investigate the relationship among the latest WHO classification of thymoma,myasthenia gravis (MG) and clinical stages. Methods: To review the pathological sections of 74 patientswith thymoma from 1980-2004 using WHO classification (1999), the statistical software was used to analyzethe relationship among the WHO classification, MG and clinical stages. Results: (1) Two cases of typeA, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type Cwere classified. Type B2 more likely accompanied MG (P<0.05), while none with MG occurred for typeC. (2) One patient was in stage I, 30 were in stage II, 38 were in stage III, and 5 were in stage IV. Thelatest histologic classification was significantly correlated with Masaoka stages (P<0.01). Conclusion:The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. Itcan also evaluate the prognosis of patients.