The impact of immune markers on thymectomy prognosis in thymoma-myasthenia gravis.

BACKGROUND

Research shows that thymoma-associated myasthenia gravis (MG) patients exhibit immunological imbalances, including anomalies in immune indicators. The link between these abnormalities and thymectomy outcomes is not well-understood. This study aims to assess the impact of immunological markers like T helper (Th)17 cells, regulatory T (Treg) cells, CD4+ T, CD8+ T cells, immunoglobulin (Ig)G, IgA, IgM, IgE, C-reactive protein (CRP), complement C3, and complement C4 on MG prognosis post-thymectomy.

METHODS

A retrospective analysis of 163 MG patients undergoing thymectomy between January 2011 and December 2022 at our institution was conducted. We explored the association between preoperative blood immunological markers and prognosis using Kaplan-Meier survival curves and the Cox model. The main goal was to determine if these patients could achieve postoperative sustained remission.

RESULTS

Out of 163 patients, 77 reached sustained remission, 79 showed no change or worsening of MG, including recurrences, and 7 died from severe MG over an average of 68.2 months. A significant finding was that reduced complement C3 levels (P<0.001) correlated with a failure to achieve remission. Other immunological markers, including T cell levels and IgG, showed no prognostic significance.

CONCLUSIONS

Complement C3 level is a crucial predictor for long-term remission in thymoma-associated MG post-thymectomy. Patients with lower C3 levels are more likely to experience MG symptom progression post-surgery compared to those with normal levels, indicating its potential as a key prognostic marker.