合并重症肌无力的胸腺瘤患者术后生存的初步分析--ChART数据库回顾性结果
背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确，本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国胸腺协作组（Chinese Alliance for Research in hTymomas, ChART）数据库录入的18个胸外科中心诊断胸腺瘤并接受相关手术的患者分为合并重症肌无力组（合并组）和单纯胸腺瘤组（对照组）。收集两组患者的人口学资料及临床资料，比较两组患者生存率。结果共1,850例患者纳入研究，其中合并肌无力组及单纯胸腺瘤组分别421人和1429人，行胸腺全切的比例分别是91.2%和71.0%...
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| Published in | 中国肺癌杂志 Vol. 19; no. 7; pp. 418 - 424 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
复旦大学附属华山医院胸外科,上海,200032%中山大学附属肿瘤医院胸外科,广州,510060%青岛大学医学院附属医院胸外科,青岛,266001%复旦大学附属中山医院胸外科,上海,200032%天津医科大学附属总医院胸外科,天津,300052%610041成都，四川省肿瘤医院胸外科，马可%福建医科大学附属协和医院胸外科,福州,350001%安徽医科大学附属第一医院胸外科,合肥,230022%郑州大学附属肿瘤医院胸外科,郑州,450008%北京大学附肿瘤医院胸外科,北京,100142%长海医院胸心外科,上海,200433%辽宁肿瘤医院胸外科,沈阳,110042%吉林大学附属第一医院胸外科,长春,130021%四川大学华西医院胸外科,成都,610041%天津医科大学附属肿瘤医院食管癌中心,天津,300060%浙江省肿瘤医院胸外科,杭州,310022%江西省人民医院胸外科,南昌,330006%上海交通大学附属上海胸科医院,上海,200030
2016
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| Online Access | Get full text |
| ISSN | 1009-3419 1999-6187 |
| DOI | 10.3779/j.issn.1009-3419.2016.07.03 |
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| Abstract | 背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确，本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国胸腺协作组（Chinese Alliance for Research in hTymomas, ChART）数据库录入的18个胸外科中心诊断胸腺瘤并接受相关手术的患者分为合并重症肌无力组（合并组）和单纯胸腺瘤组（对照组）。收集两组患者的人口学资料及临床资料，比较两组患者生存率。结果共1,850例患者纳入研究，其中合并肌无力组及单纯胸腺瘤组分别421人和1429人，行胸腺全切的比例分别是91.2%和71.0%（P＜0.05）；肌无力组患者的WHO病理类型多分布于AB、B1和B2型，优于单纯胸腺瘤组（P＜0.05）；合并肌无力组的Masaoka分期较早（I和II期）的比例高于单纯胸腺瘤组。5年和10年的总体生存率在MG组和非MG组中分别为93%和88%；83%和81%（P=0.034）；在Masaoka III、IVa和IVb期胸腺瘤患者中，合并肌无力患者的生存曲线高于单纯胸腺瘤患者（P=0.003）。在进展型胸腺瘤患者中，MG组和非MG组患者的Masaoka III、IVa、IVb的构成比相似，组织学结果中，MG组的AB/B1/B2/B3型的比例高于C型比例更高的非MG组（P＜0.001）。整体的单因素分析结果提示，MG、WHO分型、Masaoka分期、手术方式、化疗、放疗和临床切除状况均为预后的影响因素。而在多因素分析中，WHO分型、Masaoka分期和临床切除状况是独立的预后预测指标。结论虽然重症肌无力不是独立的预后影响因素，但是在胸腺瘤患者中，合并MG的患者预后较优，尤其是Masaoka分期晚期的患者，可能与疾病的早期发现、病理类型分布相对较好、整体R0切除率较高以及复发率较低有关。 |
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| AbstractList | 背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确，本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国胸腺协作组（Chinese Alliance for Research in hTymomas, ChART）数据库录入的18个胸外科中心诊断胸腺瘤并接受相关手术的患者分为合并重症肌无力组（合并组）和单纯胸腺瘤组（对照组）。收集两组患者的人口学资料及临床资料，比较两组患者生存率。结果共1,850例患者纳入研究，其中合并肌无力组及单纯胸腺瘤组分别421人和1429人，行胸腺全切的比例分别是91.2%和71.0%（P<0.05）；肌无力组患者的WHO病理类型多分布于AB、B1和B2型，优于单纯胸腺瘤组（P<0.05）；合并肌无力组的Masaoka分期较早（I和II期）的比例高于单纯胸腺瘤组。5年和10年的总体生存率在MG组和非MG组中分别为93%和88%；83%和81%（P=0.034）；在Masaoka III、IVa和IVb期胸腺瘤患者中，合并肌无力患者的生存曲线高于单纯胸腺瘤患者（P=0.003）。在进展型胸腺瘤患者中，MG组和非MG组患者的Masaoka III、IVa、IVb的构成比相似，组织学结果中，MG组的AB/B1/B2/B3型的比例高于C型比例更高的非MG组（P<0.001）。整体的单因素分析结果提示，MG、WHO分型、Masaoka分期、手术方式、化疗、放疗和临床切除状况均为预后的影响因素。而在多因素分析中，WHO分型、Masaoka分期和临床切除状况是独立的预后预测指标。结论虽然重症肌无力不是独立的预后影响因素，但是在胸腺瘤患者中，合并MG的患者预后较优，尤其是Masaoka分期晚期的患者，可能与疾病的早期发现、病理类型分布相对较好、整体R0切除率较高以及复发率较低有关。 背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确，本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国胸腺协作组（Chinese Alliance for Research in hTymomas, ChART）数据库录入的18个胸外科中心诊断胸腺瘤并接受相关手术的患者分为合并重症肌无力组（合并组）和单纯胸腺瘤组（对照组）。收集两组患者的人口学资料及临床资料，比较两组患者生存率。结果共1,850例患者纳入研究，其中合并肌无力组及单纯胸腺瘤组分别421人和1429人，行胸腺全切的比例分别是91.2%和71.0%（P＜0.05）；肌无力组患者的WHO病理类型多分布于AB、B1和B2型，优于单纯胸腺瘤组（P＜0.05）；合并肌无力组的Masaoka分期较早（I和II期）的比例高于单纯胸腺瘤组。5年和10年的总体生存率在MG组和非MG组中分别为93%和88%；83%和81%（P=0.034）；在Masaoka III、IVa和IVb期胸腺瘤患者中，合并肌无力患者的生存曲线高于单纯胸腺瘤患者（P=0.003）。在进展型胸腺瘤患者中，MG组和非MG组患者的Masaoka III、IVa、IVb的构成比相似，组织学结果中，MG组的AB/B1/B2/B3型的比例高于C型比例更高的非MG组（P＜0.001）。整体的单因素分析结果提示，MG、WHO分型、Masaoka分期、手术方式、化疗、放疗和临床切除状况均为预后的影响因素。而在多因素分析中，WHO分型、Masaoka分期和临床切除状况是独立的预后预测指标。结论虽然重症肌无力不是独立的预后影响因素，但是在胸腺瘤患者中，合并MG的患者预后较优，尤其是Masaoka分期晚期的患者，可能与疾病的早期发现、病理类型分布相对较好、整体R0切除率较高以及复发率较低有关。 |
| Abstract_FL | Background and objectiveIt is so far not clear that how myasthenia gravis (MG) affected the prognosis of thymoma patients. The aim of this assay is to compare the postoperative survival between patients with thymoma only and those with both thymoma and MG.MethodsThe Chinese Alliance for Research in Thymomas (ChART) registry recruited patients with thymoma from 18 centers over the country on an intention to treat basis from 1992 to 2012. Two groups were formed according to whether the patient complicated MG. Demographic and clinical data were reviewed, Patients were fol-lowed and their survival status were analyzed.Results There were 1,850 patients included in this study, including 421 with and 1,429 without MG. Complete thymectomy were done in 91.2% patients in MG group and 71.0% in non-MG group (P<0.05). There were more percentage of patients with the histology of thymoma AB, B1, or B2 (P<0.05) in MG group, and more percentage of patients with MG were in Masaoka stage I and II. The 5 year and 10 year OS rates were both higher in MG group (93%vs 88%; 83%vs 81%,P=0.034) respectively. The survival rate was signiifcantly higher in patients with MG when the Masaoka staging was III/IV (P=0.003). Among patients with advanced stage thymoma (stage III, IVa, IVb), the constitu-ent ratios of III, IVa, IVb were similar between MG and Non-MG group. Histologically, however, there were signiifcantly more proportion of AB/B1/B2/B3 in the MG group while there were more C in the non-MG group (P=0.000). Univariate analyses for all patients showed that MG, WHO classiifcation, Masaoka stage, surgical approach, chemotherapy and radiotherapy and resectability were signiifcant factors, and multivariate analysis showed WHO Classiifcation, Masaoka stage, and resectability were strong independent prognostic indicators.ConclusionAlthough MG is not an independent prognostic factor, the sur-vival of patients with thymoma was superior when MG was present, especially in late Masaoka stage patients. Possible reasons included early diagnosis of the tumor, better histologic types, an overall higher R0 resection and less recurrence. |
| Author | 汪昉睿 庞烈文 傅剑华 沈毅 魏煜程 谭黎杰 张鹏 韩泳涛 陈椿 张仁泉 李印 陈克能 陈和忠 刘永煜 崔有斌 王允 于振涛 周鑫明 柳阳春 刘媛 谷志涛 方文涛 |
| AuthorAffiliation | 复旦大学附属华山医院胸外科,上海200032 中山大学附属肿瘤医院胸外科,广州510060 青岛大学医学院附属医院胸外科,青岛266001 复旦大学附属中山医院胸外科,上海200032 天津医科大学附属总医院胸外科,天津300052 四川省肿瘤医院胸外科,成都610041 福建医科大学附属协和医院胸外科,福州350001 安徽医科大学附属第一医院胸外科,合肥230022 郑州大学附属肿瘤医院胸外科,郑州450008 北京大学附肿瘤医院胸外科,北京100142 长海医院胸心外科,上海200433 辽宁肿瘤医院胸外科,沈阳110042 吉林大学附属第一医院胸外科,长春130021 四川大学华西医院胸外科,成都610041 天津医科大学附属肿瘤医院食管癌中心,天津300060 浙江省肿瘤医院胸外科,杭州310022 江西省人民医院胸外科,南昌330006 上海交通大学附属上海胸科医院,上海200030 |
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| Author_FL | Hezhong CHEN Chun CHEN Youbing CUI Yuan LIU Jianhua FU Lijie TAN Yin LI Xinming ZHOU Renquan ZHANG Zhentao YU Yi SHEN Liewen PANG Yucheng WEI Yongyu LIU Yun WANG Zhitao GU Yangchun LIU Yongtao HAN Fangrui WANG Ke-Neng CHEN Peng ZHANG Wentao FANG |
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| Copyright | Copyright © Wanfang Data Co. Ltd. All Rights Reserved. |
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| Keywords | Thymoma 重症肌无力 生存率 Survival 胸腺瘤 Myasthenia gravis (MG) |
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| Notes | Fangrui WANG, Liewen PANG, Jianhua FU, Yi SHEN, Yucheng WEI, Lijie TAN, Peng ZHANG, Yongtao HAN, Chun CHEN, Renquan ZHANG, Yin LI, Ke-Neng CHEN, Hezhong CHEN, Yongyu LIU, Youbing CUI, Yun WANG, Zhentao YU, Xinming ZHOU, Yangchun LIU, Yuan LIU, Zhitao GU, Wentao FANG （1Department of Thoracic Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China; 2Department of Thoracic Surgery, Guangdong Esophageal Cancer Institute, Sun Yabsen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou S10060, China; 3Department of Thoracic Surgery, Affiliated Hos- pital of Qingdao University, Qingdao 266001, China; 4Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China; SDepartment of Endocrinology, Tianjin Medical University General Hospital, Tianjin 300052, China; 6Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041, China; 7Department of Thoracic Surgery, Fujian Medi- cal Uni |
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| PublicationTitle | 中国肺癌杂志 |
| PublicationTitleAlternate | Chinese Journal of Lung Cancer |
| PublicationYear | 2016 |
| Publisher | 复旦大学附属华山医院胸外科,上海,200032%中山大学附属肿瘤医院胸外科,广州,510060%青岛大学医学院附属医院胸外科,青岛,266001%复旦大学附属中山医院胸外科,上海,200032%天津医科大学附属总医院胸外科,天津,300052%610041成都，四川省肿瘤医院胸外科，马可%福建医科大学附属协和医院胸外科,福州,350001%安徽医科大学附属第一医院胸外科,合肥,230022%郑州大学附属肿瘤医院胸外科,郑州,450008%北京大学附肿瘤医院胸外科,北京,100142%长海医院胸心外科,上海,200433%辽宁肿瘤医院胸外科,沈阳,110042%吉林大学附属第一医院胸外科,长春,130021%四川大学华西医院胸外科,成都,610041%天津医科大学附属肿瘤医院食管癌中心,天津,300060%浙江省肿瘤医院胸外科,杭州,310022%江西省人民医院胸外科,南昌,330006%上海交通大学附属上海胸科医院,上海,200030 |
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| Snippet | 背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确，本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国... |
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| SourceType | Aggregation Database Publisher |
| StartPage | 418 |
| SubjectTerms | 生存率 胸腺瘤 重症肌无力 |
| Title | 合并重症肌无力的胸腺瘤患者术后生存的初步分析--ChART数据库回顾性结果 |
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| Volume | 19 |
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