CAJ | 학술논문

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。
목적　탐토흉선류병리분형、병리분기화중증기무력(MG)지간관계。방법　분석1986～1996년 88례경수술증실위흉선류환자，기중28례술전합병MG，분석저28례환자흉선류병리분형、병리분기여MG발생년령、성별、Osserman림상분형급술후MG완해가중관계특점。결과　발현흉선류반유MG28례(31.8%)；기중남18례점64.3%；녀10례점35.7%；발병년령이40～59세위고봉기，공20례，점71.4%；병리분형증실상피세포형흉선류MG발병솔고，차림상증상중，이Osserman림상분형Ⅱa,Ⅱb형위주，기무력위상발생솔고，사망솔고；기차위상피림파세포혼합형흉선류。상피세포형흉선류술후MG증상완해후재가중다우혼합형흉선류。증상가중다견우술후3～12개월。28례환자Masaoka병리분기I기8례，Ⅱ기10례，Ⅲ기10례；I기이Osserman림상분형I형위주，술후무MG증상완해후재가중；Ⅱ、Ⅲ기이Ⅱa、Ⅱb형위주，술후MG증상완해후재가중비솔고。결론　흉선류반MG환자이남성다견，발병년령이40～59세위주，이상피세포형위주，Masaoka병리분기위Ⅱ、Ⅲ기흉선류MG림상증상중，차술후MG증상완해후역재가중。
Objective　To study relationship between Masaoka pathological stage and type of thymoma and myasthenia gravis. Methods　To analyse pathological sections and clinical manifestations of 88 cases who had received thymectomy from 1986 to 1996. Among the 88 cases, 28 cases were MG.　The pathological stage and type, age, sex and Osserman type were analysed between thymoma and MG. Results　28 cases with the thymoma complicated by MG is presented (31.8%) including male 18 and female 10 cases. 20 cases from 40～59 years old patients were at peak periods (71.4%). The incidence of epithelial cell type thymoma complicated by MG has raised and its clinical symptom was serious. The epithelial cell type was relied on Osserman type Ⅱa and Ⅱb.The incidence and death rate of MG crisis has raised. 28 cases of thymoma were accompanied with MG and Masaoka pathological stage. The first ,second and third stages were 8, 10, and 10 cases respectively ; 1st stage was relied mainly on Osserman type I, 2nd and 3rd stages were relied mainly on Osserman type Ⅱa and Ⅱb. Conclusion　Thymoma complicated by MG relies mainly on male and on epithelial cell type . Masaoka pathological stager also relies on Ⅱ, and Ⅲ , and clinical symptom is serious.