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目的 探讨胸腺瘤病理分型、病理分期和重症肌无力(MG)之间关系。方法 分析1986～1996年 88例经手术证实为胸腺瘤患者，其中28例术前合并MG，分析这28例患者胸腺瘤病理分型、病理分期与MG发生年龄、性别、Osserman临床分型及术后MG缓解加重关系特点。结果 发现胸腺瘤伴有MG28例(31.8%)；其中男18例占64.3%；女10例占35.7%；发病年龄以40～59岁为高峰期，共20例，占71.4%；病理分型证实上皮细胞型胸腺瘤MG发病率高，且临床症状重，以Osserman临床分型Ⅱa,Ⅱb型为主，肌无力危象发生率高，死亡率高；其次为上皮淋巴细胞混合型胸腺瘤。上皮细胞型胸腺瘤术后MG症状缓解后再加重多于混合型胸腺瘤。症状加重多见于术后3～12个月。28例患者Masaoka病理分期I期8例，Ⅱ期10例，Ⅲ期10例；I期以Osserman临床分型I型为主，术后无MG症状缓解后再加重；Ⅱ、Ⅲ期以Ⅱa、Ⅱb型为主，术后MG症状缓解后再加重比率高。结论 胸腺瘤伴MG患者以男性多见，发病年龄以40～59岁为主，以上皮细胞型为主，Masaoka病理分期为Ⅱ、Ⅲ期胸腺瘤MG临床症状重，且术后MG症状缓解后易再加重。
Objective To investigate the relationship between histopathology, pathological stage and myasthenia gravis (MG) in thymoma. Methods 88 cases of thymoma confirmed by operation from 1986 to 1996 were analyzed. Among them, 28 cases were preoperatively combined with MG. The pathological types of thymoma were analyzed in 28 cases. The age, gender, Osserman clinical classification and operation After the MG to ease the relationship between the characteristics of aggravating. The results showed that thymoma with MG28 cases (31.8%); of which 18 cases accounted for 64.3% of males; 10 females accounted for 35.7%; age of onset of 40 to 59 years old for the peak, a total of 20 cases, accounting for 71.4%; pathological type Confirmed the high incidence of epithelial cell thymomas MG, and clinical symptoms, Osserman clinical classification of type Ⅱ a, Ⅱ b, the high incidence of myasthenic crisis, the high mortality rate; followed by epithelial lymphocyte mixed thymoma. Epithelial-type thymoma postoperative MG symptoms re-aggravated more than mixed thymoma. More common in postoperative symptoms 3 to 12 months. 28 cases of Masaoka stage I of 8 cases, 10 cases of stage II, 10 cases of stage III; Osserman stage I type I-based, no symptoms of MG after re-aggravation; II, III to IIa, Ⅱ b-based, postoperative MG symptoms re-exacerbated after the high rate. Conclusion Thymoma with MG patients more common in men, the age of onset to 40 to 59-year-old, mainly epithelial cell type, Masaoka pathological stage Ⅱ, Ⅲ thymoma MG clinical symptoms, and postoperative MG symptoms were relieved Easy to increase.