Relationships between the pathology classification, Masaoka clinical stage and postoperation myasthenic crisis in patients of myasthenia gravis with thymoma
10.3760/cma.j.issn.1673-4904.2018.07.014
- VernacularTitle:合并胸腺瘤的重症肌无力患者术后并发肌无力危象与病理分型和临床分期的相关性分析
- Author:
Shui XIANG
1
;
Jinqi HUANG
;
Yong ZHENG
;
Hongling HUANG
;
Yanli CAI
;
Yuanbo YAO
;
Xu LI
Author Information
1. 445000,湖北省恩施土家族苗族自治州中心医院心胸外科
- Keywords:
Myasthenia gravis;
Thymoma;
Myasthenic crisis;
WHO pathology classification
- From:
Chinese Journal of Postgraduates of Medicine
2018;41(7):633-636
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationships between the pathology classification, Masaoka clinical stage and postoperation myasthenic crisis in patients of myasthenia gravis with thymoma undergoing thymectomy. Methods Clinical records of 56 patients of myasthenia gravis with thymoma from January 2006 to December 2015 who had underwent thymectomy were reviewed retrospectively. The following factors were analyzed to find the relation to the occurrence of myasthenic crisis after thymectomy: WHO pathology classification, Masaoka clinical stage and tumor size. Results Sixteen patients experienced postoperative myasthenic crisis after thymectomy. Statistical analysis revealed that the incidence of postoperative myasthenic crisis in patients with Masaoka Ⅲ stage was significantly higher than that in patients with Masaoka Ⅰ and Ⅱ stage: 39.39% (13/33) vs. 13.04% (3/23), the incidence of postoperative myasthenic crisis in patients with WHO pathology classification B3 and C type was significantly higher than patients with WHO pathology classification B2 type: 50.00% (12/24) vs. 14.29% (4/28), the incidence of postoperative myasthenic crisis in patients with tumor size more than 5 cm was significantly lower than patients with tumor size less than 5 cm: 10/17 vs. 15.38% (6/39), and there were statistical differences (P＜0.05 or＜0.01). Conclusions WHO pathology classification and Masaoka clinical stage are significantly correlated with the occurrence of myasthenia crisis after thymectomy. The patients with MasaokaⅢstage, WHO pathology classification B3 and C type and tumor size more than 5 cm have the risk of postoperative myasthenic crisis after thymectomy. The comprehensive intervention before and after operation can prevent myasthenia crisis.
