11例Ⅳ期胸腺瘤患者的诊治分析  

Diagnosis and treatment of 11 patients with stage Ⅳ thymoma

作　　者：万璐 白春梅 WAN Lu;BAI Chunmei(Department of Internal Medical,Peking Union Medical College Hospital,Beijing 100730,China;Department of Medical Oncology,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内科,北京1007300 [2]中国医学科学院北京协和医学院北京协和医院肿瘤内科,北京1007300

出　　处：《癌症进展》2019年第21期2535-2539,共5页Oncology Progress

摘　　要：目的通过分析Ⅳ期胸腺瘤患者的临床特点、治疗方式及预后,提高临床医师对该病的诊断和治疗水平。方法回顾性分析和总结11例Ⅳ期胸腺瘤患者的临床特点、Masaoka分期、组织学分型、治疗方法及预后等资料。结果11例Ⅳ期胸腺瘤患者中,男6例,女5例,中位发病年龄为49岁。以胸闷、憋气起病5例,胸痛起病1例,咯血起病1例,重症肌无力起病2例,无明显症状2例。合并心包积液4例,胸腔积液3例,纯红细胞再生障碍性贫血1例,系统性红斑狼疮1例。组织学分型:AB型1例,B2型2例,B3型7例,另1例无法明确分型。诊断时Masaoka分期:ⅣA期6例,ⅣB期5例。3例患者接受手术治疗,均为姑息性切除,其中2例患者术后行放疗+化疗,1例患者术后仅行化疗。其余8例患者未接受手术治疗,其中3例患者接受单纯化疗,5例患者接受放疗+化疗。至随访截止时间,2例患者死亡,自确诊起生存期均超过10年。结论通过多学科综合治疗可显著改善Ⅳ期胸腺瘤患者预后,延长其生存时间。Objective To improve the diagnosis and treatment of stageⅣthymoma by analyzing the clinical features,treatment methods and prognosis of patients.Method The clinical characteristics,Masaoka stage,histological classification,treatment and prognosis of 11 patients with stageⅣthymoma were retrospectively analyzed.Result Among the 11 patients,6 were male and 5 were female.The median age of onset was 49 years.There were 5 cases of chest tightness or suffocation,1 case of chest pain,1 case of hemoptysis,2 cases of myasthenia gravis,2 cases without obvious symptoms.There were 4 cases of pericardial effusion,3 cases of pleural effusion,1 case of pure erythrocyte aplastic anemia,and 1 case of systemic lupus erythematosus.1 case was type AB,2 cases were type B2,7 cases were type B3 and 1 case was unclassified.At the time of diagnosis,there were 6 cases of Masaoka stageⅣA and 5 cases ofⅣB stage.3 patients received surgical treatment,all of whom were palliative resection.2 patients received postoperative radiotherapy and chemotherapy.1 patient received postoperative chemotherapy.The remaining 8 patients were not treated by operation,among them 3 patients received chemotherapy alone,and 5 patients received radiotherapy and chemotherapy.By the end of follow-up,2 patients which survival period was more than 10 years were died.Conclusion Multidisciplinary and comprehensive treatment for advanced thymoma can significantly improve the prognosis and prolong the survival time.

关 键 词：Ⅳ期胸腺瘤 临床特点 治疗 预后 

分 类 号：R736.3[医药卫生—肿瘤]