胸腺瘤的外科治疗及临床病理分析  

Surgical therapy and pathological analysis of thymoma

作　　者：李昕[1] 张韶岩[1] 区颂雷[1] 宋飞强[1] 胡燕生[1] 马旭晨[1] 

机构地区：[1]首都医科大学附属北京安贞医院胸外科,100029

出　　处：《中国医药》2010年第5期420-422,共3页China Medicine

摘　　要：目的分析手术治疗胸腺瘤的临床效果及胸腺瘤分期与病理分型与预后的关系。方法总结接受不同手术方法治疗的胸腺瘤患者104例，对手术疗效、病变分期、病理分型、生存率等临床资料进行分析。结果全部患者无手术死亡及术后死亡，完全切除率92．3％，并发症发生率3．8％。Masaoka分期：I期26．9％，II期40．4％，III期28．9％，IVa期3．8％。WHO分型A型3．8％，AB型8．7％，B1型22．1％，B2型42．3％，133型17．3％，C型5．8％。术后随访（62．3±18．5）个月。术后1年存活率为98．1％，3年存活率88．5％，5年存活率82．3％。III期、IV期和B3型、C型病变各期存活率明显下降。结论手术治疗胸腺瘤安全有效。术后存活率与病理分型、病变分期相关，III期、IV期和B3型、C型病变预后不良。Objective To explore the results of surgical treatment for thymoma, and to investigate the influence of pathological predictors on long-term survival. Methods The clinical and pathologic features of 104 cases from 2000 to 2009 underwent surgical treatment for thymoma were reviewed. The prognostic factors against postoperative survival were analyzed. Results The rate of complete resection was 92.3%. The morbidity was 3.8% and no death happened perioperatively. Thymomas were staged according to the Masaoka system as 26.9% stage I , 40. 4% stage II , 28.8% stage III, 3.8% stage IVa and classified according to the World Health Organization system as3.8% type A, 8.6% typeAB, 22.1% type B1,43.3% type B2,17.3% type B3, 5.8% type C. Mean follow- up was 52.3 ± 18.5 months. The overall 1-, 3- and 5-yearsurvival rates were 98.1% ,88.5 and 82.3%, respectively. The Masaoka staging and the World Health Organization classification significantly influenced the long-term survival. Stage 19, IVa, type B3 and type C were related with worse prognosis. Conclusions Surgical method is safe and effective in the treatment of thymoma. The clinical staging and the histologic classification influence long-term survival.

关 键 词：胸腺瘤 外科治疗 病理 

分 类 号：R655.5[医药卫生—外科学]