CAJ | 학술논문

目的　研究Müller-Hermelink组织发生学分类及其临床意义。方法　76例胸腺瘤采用Müller-Hermelink分类方法进行分类，分析胸腺瘤类型与伴发重症肌无力、浸润性及患者预后关系。结果　髓质型和混合型胸腺瘤大多包膜完整（72％），仅少数病例（28％）浸润包膜或周围脂肪组织；皮质为主型胸腺瘤中度浸润；皮质型胸腺瘤和分化良好胸腺癌浸润性较大，56％浸润周围器官，20％浸润包膜或周围脂肪组织，仅24%包膜完整；其它类型胸腺癌均浸润周围器官、胸腔内或淋巴转移。皮质型胸腺瘤和分化良好胸腺癌较髓质型和混合型更易伴发重症肌无力（分别为92%和32%，P结论　胸腺瘤类型与肿瘤浸润、伴发重症肌无力和预后明显相关。
목적　연구Müller-Hermelink조직발생학분류급기림상의의。방법　76례흉선류채용Müller-Hermelink분류방법진행분류，분석흉선류류형여반발중증기무력、침윤성급환자예후관계。결과　수질형화혼합형흉선류대다포막완정（72％），부소수병례（28％）침윤포막혹주위지방조직；피질위주형흉선류중도침윤；피질형흉선류화분화량호흉선암침윤성교대，56％침윤주위기관，20％침윤포막혹주위지방조직，부24%포막완정；기타류형흉선암균침윤주위기관、흉강내혹림파전이。피질형흉선류화분화량호흉선암교수질형화혼합형경역반발중증기무력（분별위92%화32%，P결론　흉선류류형여종류침윤、반발중증기무력화예후명현상관。
Objective　 To evaluate the method of thymoma classification by Müller-Hermelink and colleagues applying clinical practice. Methods　Seventy-six cases of thymomas were retrospectively studied the relationship between their subtypes and myathenia gravis,invasiveness and prognosis were analyzed . Results　All medullary and mixed thymomas were either completely encapsulated (72%) or invasive through the capsule into mediastinal fat(28%).The predominant cortical thymomas were intermediate degree of invasiveness.Cortical thymomas and well-differentiated thymic carcinomas showed more invasive,with 56% invasive into adjacent structures and 20% into mediastinal fat through capsule,only 24% completely encapsulated.Other thymic carcinomas were invasive into adjacent structures,pleural seeding or lymph node metastasis.There was an increased cortical thymomas，well-differentiated thymic carcinomas in company with myasthenia gravis.The survival rate was significantly higher for patients with medullary and mixed thymomas than for patients with cortical thymomas and well-differentiated thymic carcinomas. Conclusion　There was a strong correlation between histologic subtype of thymoma associated myasthenia gravis,as well as prognosis.