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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。
Objective To investigate the relationship between the latest WHO histological classification of thymoma and myasthenia gravis (MG) and its clinical stage. Methods A retrospective analysis of 74 patients with thymectomy for thymoma between 1980 and 2004 was performed to reclassify the thymoma using the latest WHO classification criteria (1999). The statistical software was used to analyze the difference between the new WHO histological classification and the incidence of MG And Masaoka clinical staging of the relationship between further analysis. Results (1) Thymoma type A in 2 cases, AB type in 23 cases, B1 type in 4 cases, B2 type in 27 cases, B3 type in 16 cases and C type in 2 cases. Among them, type B2 was more likely to be associated with MG than type AB, B1 and B3 (P <0.05), type A both combined with MG, and type C did not with MG. (2) Clinical stage I: 1 case, stage Ⅱ: 30 cases, stage Ⅲ: 38 cases and stage Ⅳ: 5 cases. The new WHO histological type and Masaoka staging are closely related (P <0.01). Conclusion There is a relationship between the histological classification of new WHO and the incidence of thymoma combined with MG. It can also reflect the clinical stage and evaluate the prognosis of patients.