Nakajima J, Takamoto S, Oka T, Tanaka M, Takeuchi E, Murakawa T
Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Eur J Cardiothorac Surg. 2000 Sep;18(3):287-92. doi: 10.1016/s1010-7940(00)00523-6.
There have been conflicts concerning the criteria for diagnosing malignant epithelial neoplasms of thymic origin. To differentiate thymic carcinomas from thymomas, the maturation stage of T-lineage lymphoid cells infiltrating thymomas and thymic carcinomas was examined by flow cytometry to associate it with the degree of tumor malignancy.
Multidimensional flow cytometric analysis was performed on the lymphoid cells extracted from 27 thymic epithelial neoplasms (14 encapsulated thymomas, ten invasive thymomas, and three thymic carcinomas) by using anti-CD3, -CD4, -CD8, -CD10, -CD20, -CD38, -CD45RA, and -CD45RO monoclonal antibodies.
CD4 and CD8 were co-expressed on 76.8% of the lymphoid cells in encapsulated thymoma (N=14), 59.2% in invasive thymoma (N=10), and 6.7% in thymic cancer (N=3). The percentage of CD4- or CD8- single positive cells was 11.4% in encapsulated thymoma, 23.9% in invasive thymoma, and 77.7% in thymic cancer. The percentage of CD10-positive cells was 20.8% in encapsulated thymoma, 13.2% in invasive thymoma, and 6.0% in thymic cancer. The percentage of CD20-positive cell was 2.6% in encapsulated thymoma, 3.3% in invasive thymoma, and 31.6% in thymic cancer. There were significant statistical differences in the percentages of CD4/CD8 double positive cells, CD4- or CD8-single positive cells, CD10-positive cells and CD20-positive cells among the three groups. Two cases classified as invasive thymoma by pathohistological examination, however, showed the infiltration of mature lymphocytes like as thymic cancers.
CD4+CD8+ or CD10+ T-lineage cells were the most reliable markers of the benignancy of thymic epithelial tumors. CD4- or CD8-single positive cells or CD20-positive cells were characteristic in thymic carcinoma. Flow cytometry on the maturity of lymphoid cells infiltrating thymic epithelial tumors was feasible for determining their degree of malignancy. Some invasive thymomas showed the intermediate characteristics with thymomatous epithelia and mature lymphoid cells.
关于胸腺来源的恶性上皮性肿瘤的诊断标准一直存在争议。为了区分胸腺癌和胸腺瘤，通过流式细胞术检测浸润胸腺瘤和胸腺癌的T细胞系淋巴细胞的成熟阶段，以将其与肿瘤恶性程度相关联。
使用抗CD3、-CD4、-CD8、-CD10、-CD20、-CD38、-CD45RA和-CD45RO单克隆抗体，对从27例胸腺上皮性肿瘤（14例包膜型胸腺瘤、10例浸润性胸腺瘤和3例胸腺癌）中提取的淋巴细胞进行多参数流式细胞术分析。
在包膜型胸腺瘤（n = 14）中，76.8%的淋巴细胞共表达CD4和CD8；在浸润性胸腺瘤（n = 10）中为59.2%；在胸腺癌（n = 3）中为6.7%。CD4或CD8单阳性细胞的百分比在包膜型胸腺瘤中为11.4%，在浸润性胸腺瘤中为23.9%，在胸腺癌中为77.7%。CD10阳性细胞的百分比在包膜型胸腺瘤中为20.8%，在浸润性胸腺瘤中为$13.2%$，在胸腺癌中为6.0%。CD20阳性细胞的百分比在包膜型胸腺瘤中为2.6%，在浸润性胸腺瘤中为3.3%，在胸腺癌中为31.6%。三组之间CD4/CD8双阳性细胞、CD4或CD8单阳性细胞、CD10阳性细胞和CD20阳性细胞的百分比存在显著统计学差异。然而，2例经病理组织学检查分类为浸润性胸腺瘤的病例显示出类似胸腺癌的成熟淋巴细胞浸润。
CD4+CD8+或CD10+ T细胞系细胞是胸腺上皮性肿瘤良性的最可靠标志物。CD4或CD8单阳性细胞或CD20阳性细胞是胸腺癌的特征。对浸润胸腺上皮性肿瘤的淋巴细胞成熟度进行流式细胞术检测对于确定其恶性程度是可行的。一些浸润性胸腺瘤表现出胸腺瘤上皮和成熟淋巴细胞的中间特征。
