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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2016, Vol. 25 Issue (1): 37-41    DOI: 10.3760/cma.j.issn.1004-4221.2016.01.010
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126例胸腺瘤伴重症肌无力患者临床特点及预后
王利欢,王卫,陈玉萍,张玉海,孟少林,李杨,李月敏
100091 北京,解放军第309医院肿瘤放疗科(王利欢、张玉海、孟少林、李月敏),神经内科(王卫、陈玉萍);075000 张家口,河北北方学院研究生部(王利欢);100850 北京,军事医学科学院放射医学研究所(李杨)
Clinical features and prognosis of thymoma with myasthenia gravis:an analysis of 126 patients
Wang Lihuan,Wang Wei,Chen Yuping,Zhang Yuhai,Meng Shaolin,Li Yang,Li Yuemin
Department of Radiation Oncology (Wang LH,Zhang YH,Meng SHL,Li YM),Departmentof Neurology (Wang W,Chen YP),No.309 Hospital of PLA,Beijing 100091,China;Graduate Division of Hebei North University,Zhangjiakou 075000,China (Wang LH);Institute of Radiation Medicine,Military Academy of Medical Sciences,Beijing 100850,China (Li Y)
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摘要  目的 探讨胸腺瘤伴重症肌无力患者的临床特点及预后。方法 回顾分析2008—2014年经术后病理证实的126例胸腺瘤伴重症肌无力患者的临床病理资料。Kaplan-Meier法计算生存率,Logrank法单因素预后分析,Cox法多因素预后分析。结果 全组3、5年样本量分别为88例、45例。3、5年生存率分别为97.9%、91.8%。WHO分型中A+AB+B1+B2型与B3型患者3、5年生存率分别为98.6%与95.2%、90.6%与92.9%(P=0.764)。Masaoka分期Ⅰ+Ⅱ期与Ⅲ+Ⅳ期患者3、5年生存率分别为98.6%与95.2%、97.4%与72.7%(P=0.791)。完整切除与部分切除患者3、5年生存率分别为97.8%与91.7%、100.0%与50.0%(P=0.964)。单纯完整切除与完整切除+术后放疗患者3、5年生存率分别为96.8%与93.1%、100.0%与94.7%(P=1.000)。结论 胸腺瘤伴重症肌无力患者应尽可能行完整手术切除,术后根据具体情况给予放疗。完整切除、术后放疗、WHO分型、Masaoka分期可能与预后有关。
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王利欢
王卫
陈玉萍
张玉海
孟少林
李杨
李月敏
关键词 胸腺肿瘤/外科学胸腺肿瘤/放射疗法重症肌无力/化学疗法临床病理特点预后    
Abstract:Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG). Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively. The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis. Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45, respectively (the patients who were admitted before the end of October 2011 and the end of October 2009). The 3-and 5-year survival rates were 97.9% and 91.8%, respectively. The 3-and 5-year survival rates for patients with WHO types A+AB+B1+B2 and B3 were 98.6%/95.2% and 90.6%/92.9%, respectively (P=0.764), and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-IV were 98.6%/95.2% and 97.4%/72.7%, respectively (P=0.791). The 3-and 5-year survival rates for patients with complete and partial resection were 97.8%/91.7% and 100.0%/50.0%, respectively (P=0.964), and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8%/93.1% and 100.0%/94.7%, respectively (P=1.000). Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery. Complete resection, postoperative radiotherapy, WHO type, and Masaoka stage may be associated with prognosis.
Key words Thymus neoplasms/surgery    Thymus neoplasms/radiotherapy    Myastheniagravis/chemotherapy    Clinicopathological features    Prognosis   
收稿日期: 2014-12-17     
基金资助:吴阶平医学基金(320.6750.14296);北京市首都临床特色应用研究(Z121107001012060)
通讯作者: 李月敏,Email:liyuemin224@sina.com;李杨,Email:leeyoung33@163.com   
引用本文:   
王利欢,王卫,陈玉萍等. 126例胸腺瘤伴重症肌无力患者临床特点及预后[J]. 中华放射肿瘤学杂志, 2016, 25(1): 37-41.
Wang Lihuan,Wang Wei,Chen Yuping et al. Clinical features and prognosis of thymoma with myasthenia gravis:an analysis of 126 patients[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 37-41.
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