Incidence of Thymoma in Myasthenia Gravis: A Systematic Review
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background and Purpose Myasthenia gravis (MG) is usually comorbid with thymoma. More accurate estimates of the incidence thymoma in MG will help inform patients and their physicians, facilitate health policy discussions, provide etiologic clues, and optimize the management of MG. Methods We conducted a systematic review search of relevant English-language studies published between 1960 and 2012 using MEDLINE and Embase. We identified additional studies by reviewing the bibliographies of the retrieved articles and hand searched the main neurology journals. Only incidence studies and case series of unselected MG patients in which information about thymoma were included. Results Out of 2206 potentially relevant studies, 49 met the inclusion criteria. Although there was a considerable degree of heterogeneity, the pooled estimate of the incidence of thymoma in MG was 21% (95% confidence interval, 20-22%). The pooled incidence was significantly higher for surgery-based studies than for population- and hospital-based studies. A large proportion of the reported thymomas were noninvasive. Furthermore, thymoma appears to occur significantly more frequently among male MG patients and those older than 40 years at the onset of MG. Conclusions Thymoma is common in MG patients, but appears to be found more often in male MG patients and those older than 40 years at the onset of MG. Further research is needed to expand our understanding of these association conditions
Abstract
Background and Purpose Myasthenia gravis (MG) is usually comorbid with thymoma. More accurate estimates of the incidence thymoma in MG will help inform patients and their physicians, facilitate health policy discussions, provide etiologic clues, and optimize the management of MG. Methods We conducted a systematic review search of relevant English-language studies published between 1960 and 2012 using MEDLINE and Embase. We identified additional studies by reviewing the bibliographies of the retrieved articles and hand searched the main neurology journals. Only incidence studies and case series of unselected MG patients in which information about thymoma were included. Results Out of 2206 potentially relevant studies, 49 met the inclusion criteria. Although there was a considerable degree of heterogeneity, the pooled estimate of the incidence of thymoma in MG was 21% (95% confidence interval, 20-22%). The pooled incidence was significantly higher for surgery-based studies than for population- and hospital-based studies. A large proportion of the reported thymomas were noninvasive. Furthermore, thymoma appears to occur significantly more frequently among male MG patients and those older than 40 years at the onset of MG. Conclusions Thymoma is common in MG patients, but appears to be found more often in male MG patients and those older than 40 years at the onset of MG. Further research is needed to expand our understanding of these association conditions
참고문헌 (63)
- Thomas CR, "Thymoma: state of the art", J Clin Oncol, 17, pp.2280~2289 (1999)
- Potagas C, "Myasthenia gravis: changes observed in a 30-years retrospective clinical study of a hospital-based population", J Neurol, 251, pp.116~117 (2004)
- Oosterhuis HJ, "The natural course of myasthenia gravis: a long term follow up study", J Neurol Neurosurg Psychiatry, 52, pp.1121~1127 (1989)
- Stroup DF, "Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group", JAMA, 283, pp.2008~2012 (2000)
- Pendlebury ST, "Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis", Lancet Neurol, 8, pp.1006~1018 (2009)
- Hackett ML, "Frequency of depression after stroke: a systematic review of observational studies", Stroke, 36, pp.1330~1340 (2005)
- Lew W, "Initial drug resistance and tuberculosis treatment outcomes: systematic review and meta-analysis", Ann Intern Med, 149, pp.123~134 (2008)
- Romi F, "Thymoma in myasthenia gravis: from diagnosis to treatment", Autoimmune Dis, 2011, pp.474512~ (2011)
- Castleman B, "The pathology of the thymus gland in myasthenia gravis", Ann N Y Acad Sci, 135, pp.496~505 (1966)
- Oosterhuis HJ, "Rheumatic diseases in patients with myasthenia gravis. An epidemiological and clinical investigation", Acta Neurol Scand, 44, pp.219~227 (1968)
- Mulder DG, "Thymectomy for myasthenia gravis", Am J Surg, 146, pp.61~66 (1983)
- Monden Y, "Clinical characteristics and prognosis of myasthenia gravis with other autoimmune diseases", Ann Thorac Surg, 41, pp.189~192 (1986)
- Papatestas AE, "Fagerstrom RP, Pozner J, et al. Effects of thymectomy in myasthenia gravis", Ann Surg, 206, pp.79~88 (1987)
- Giagheddu M, "Epidemiological study of myasthenia gravis in Sardinia, Italy (1958-1986)", Acta Neurol Scand, 79, pp.326~333 (1989)
- Maggi G, "Th-ymectomy in myasthenia gravis. Results of 662 cases operated upon in 15 years", Eur J Cardiothorac Surg, 3, pp.504~509 (1989)
- Thorlacius S, "Associated disorders in myasthenia gravis: autoimmune diseases and their relation to thymectomy", Acta Neurol Scand, 80, pp.290~295 (1989)
- Tola MR, "Epidemiological study of myasthenia gravis in the province of Ferrara, Italy", J Neurol, 236, pp.388~390 (1989)
- Mantegazza R, "A multicentre follow-up study of 1152 patients with myasthenia gravis in Italy", J Neurol, 237, pp.339~344 (1990)
- Ferrari G, "Epidemiology of myasthenia gravis in the province of Trento (northern Italy)", Neuroepidemiology, 11, pp.135~142 (1992)
- Yu YL, "Myasthenia gravis in Hong Kong Chinese. 1. Epidemiology and adult disease", Acta Neurol Scand, 86, pp.113~119 (1992)
- Antonini G, "Myasthenia gravis in the elderly: a hospital based study", Acta Neurol Scand, 93, pp.260~262 (1996)
- Masaoka A, "Extended thymectomy for myasthenia gravis patients: a 20-year review", Ann Thorac Surg, 62, pp.853~859 (1996)
- Nicolaou S, "Thymus in myasthenia gravis: comparison of CT and pathologic findings and clinical outcome after thymectomy", Radiology, 201, pp.471~474 (1996)
- Aiello I, "Epidemiology of myasthenia gravis in northwestern Sardinia", Neuroepidemiology, 16, pp.199~206 (1997)
- Beekman R, "Myasthenia gravis: diagnosis and follow-up of 100 consecutive patients", J Neurol, 244, pp.112~118 (1997)
- Bulkley GB, "Extended cervicomediastinal thymectomy in the integrated management of myasthenia gravis", Ann Surg, 226, pp.324~334 (1997)
- Cosi V, "Prognosis of myasthenia gravis: a retrospective study of 380 patients", J Neurol, 244, pp.548~555 (1997)
- Christensen PB, "Mortality and survival in myasthenia gravis: a Danish population based study", J Neurol Neurosurg Psychiatry, 64, pp.78~83 (1998)
- Guidetti D, "Epidemiological study of myasthenia gravis in the province of Reggio Emilia, Italy", Eur J Epidemiol, 14, pp.381~387 (1998)
- Robertson NP, "Myasthenia gravis: a population based epidemiological study in Cambridgeshire, England", J Neurol Neurosurg Psychiatry, 65, pp.492~496 (1998)
- Lavrnić D, "Epidemiological and clinical characteristics of myasthenia gravis in Belgrade, Yugoslavia (1983-1992)", Acta Neurol Sc-and, 100, pp.168~174 (1999)
- Holtsema H, "Myasthenia gravis on the Dutch antilles: an epidemiological study", Clin Neurol Neurosurg, 102, pp.195~198 (2000)
- Abt PL, "Analysis of thymectomy for myasthenia gravis in older patients: a 20-year single institution experi-ence", J Am Coll Surg, 192, pp.459~464 (2001)
- Budde JM, "Predictors of outcome in thymectomy for myasthenia gravis", Ann Thorac Surg, 72, pp.197~202 (2001)
- Fink JN, "Myasthenia gravis with thymoma is more common in the Maori and Pacific Island populations in New Zealand", Intern Med J, 31, pp.206~210 (2001)
- Mussi A, "Extended thymectomy in myasthenia gravis: a team-work of neurologist, thoracic surgeon and anaesthesist may improve the outcome", Eur J Cardiothorac Surg, 19, pp.570~575 (2001)
- de Perrot M, "Prognostic significance of thymomas in patients with myasthenia gravis", Ann Thorac Surg, 74, pp.1658~1662 (2002)
- Rastenyte D, "Demographic and clinical characteristics of patients with myasthenia gravis", Medicina (Kaunas), 38, pp.611~616 (2002)
- Remes-Troche JM, "Thymectomy in myasthenia gravis: response, complications, and associated conditions", Arch Med Res, 33, pp.545~551 (2002)
- Roth T, "Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?", Eur J Cardiothorac Surg, 21, pp.664~670 (2002)
- Au WL, "Myasthenia gravis in Singapore", Neurol J Southeast Asia, 8, pp.35~40 (2003)
- Wirtz PW, "The epidemiology of myasthenia gravis, Lambert-Eaton myasthenic syndrome and their associated tumours in the northern part of the province of South Holland", J Neurol, 250, pp.698~701 (2003)
- Casetta I, "Incid-ence of myasthenia gravis in the province of Ferrara: a community-based study", Neuroepidemiology, 23, pp.281~284 (2004)
- Yasukawa Y, "Comparative study of pre-operative thymic imaging and pathology in patients with myasthenia gravis", J Clin Neurosci, 11, pp.610~613 (2004)
- Huang CS, "Factors influencing the outcome of transsternal thymectomy for myasthenia gravis", Acta Neurol Scand, 112, pp.108~114 (2005)
- Matsuda M, "Increase in incidence of elderly-onset patients with myasthenia gravis in Nagano Prefecture", Japan. Intern Med, 44, pp.572~577 (2005)
- Levin N, "Extrathymic malignancies in patients with myasthenia gravis", J Neurol Sci, 237, pp.39~43 (2005)
- Suzuki S, "Myasthenia gravis accompanied by alopecia areata: clinical and immunogenetic aspects", Eur J Neurol, 12, pp.566~570 (2005)
- Aghajanzadeh M, "Thymectomy for myasthenia gravis: prognostic factors in 70 patients", Asian Cardiovasc Thorac Ann, 15, pp.371~375 (2007)
- Kim HK, "Neurologic outcomes of thymectomy in myasthenia gravis: comparative analysis of the effect of thymoma", J Thorac Cardiovasc Surg, 134, pp.601~607 (2007)
- Tsinzerling N, "Myasthenia gravis: a long term follow-up study of Swedish patients with specific reference to thymic histology", J Neurol Neurosurg Psychiatry, 78, pp.1109~1112 (2007)
- Al-Moallem MA, "Myasthenia gravis: presentation and outcome in 104 patients managed in a single institution", Ann Saudi Med, 28, pp.341~345 (2008)
- Singhal BS, "Myasthenia gravis: a study from India", Neurol India, 56, pp.352~355 (2008)
- Citterio A, "Risk factors for tumor occurrence in patients with myasthenia gravis", J Neurol, 256, pp.1221~1227 (2009)
- Matsui N, "Increasing incidence of elderly onset patients with myasthenia gravis in a local area of Japan", J Neurol Neurosurg Psychiatry, 80, pp.1168~1171 (2009)
- Chmura Kraemer H, "Kappa coefficients in medical research", Stat Med, 21, pp.2109~2129 (2002)
- Masaoka A, "Follow-up study of thymomas with special reference to their clinical stages", Cancer, 48, pp.2485~2492 (1981)
- Detterbeck FC, "Clinical value of the WHO classification system of thymoma", Ann Thorac Surg, 81, pp.2328~2334 (2006)
- Voltz RD, "Paraneoplastic myasthenia gravis: detection of anti-MGT30 (titin) antibodies predicts thymic epithelial tumor", Neurology, 49, pp.1454~1457 (1997)
- Chen XJ, "The significance of titin antibodies in myasthenia gravis--correlation with thymoma and severity of myasthenia gravis", J Neurol, 251, pp.1006~1011 (2004)
- Giraud M, "Genetic factors in autoimmune myasthenia gravis", Ann N Y Acad Sci, 1132, pp.180~192 (2008)
- Tomaszek S, "Thymomas: review of current clinical practice", Ann Thorac Surg, 87, pp.1973~1980 (2009)
- Meriggioli MN, "Autoimmune myasthenia gravis: emerging clinical and biological heterogeneity", Lancet Neurol, 8, pp.475~490 (2009)