Okumura M, Miyoshi S, Fujii Y, Takeuchi Y, Shiono H, Inoue M, Fukuhara K, Kadota Y, Tateyama H, Eimoto T, Matsuda H
Department of Surgery (E-1), Osaka University Graduate School of Medicine, Suita-City, Japan.
Am J Surg Pathol. 2001 Jan;25(1):103-10. doi: 10.1097/00000478-200101000-00012.
We examined the clinical and functional significance of histologic classification of thymic epithelial neoplasms proposed by the World Health Organization (WHO), based on an analysis of 146 consecutive tumors derived from 141 patients and 47 normal thymuses derived from children ranging in age from 1 to 9 years. Invasive tumors were seen in 12.5%, 38.6%, 40.0%, 69.4%, 80.0%, and 100% of type A, AB, B1, B2, B3, and C primary tumors, respectively. All of six recurrent or metastatic lesions were type B2 tumors. Myasthenia gravis was associated in 0%, 6.8%, 40.0%, 55.6%, 10.0%, and 0% in patients with type A, AB, B1, B2, B3, and C tumors, respectively. The average number (x10(6)) of tumor-associated CD4+CD8+ cells present in 1 g of tumor tissue was 1.5, 391.1, 1041.7, 333.9, 24.5, and 0.2 in type A, AB, B1, B2, B3, and C, respectively, and it was 1168.2 in the normal thymuses. Thus, type B1 tumor retained the function to induce CD4+CD8+ double-positive cells at a level comparable to that of the normal thymic cortical epithelial cells, followed by type AB and type B2 tumors. Type A and B3 tumors had this function at a barely detectable level, and type C tumor was nonfunctional. WHO histologic classification was shown to reflect the clinical features and the T-cell-inducing function of thymic epithelial tumors.
我们基于对141例患者的146例连续性肿瘤以及47例年龄在1至9岁儿童的正常胸腺的分析，研究了世界卫生组织（WHO）提出的胸腺上皮肿瘤组织学分类的临床和功能意义。侵袭性肿瘤在A型、AB型、B1型、B2型、B3型和C型原发性肿瘤中分别占12.5%、38.6%、40.0%、69.4%、80.0%和100%。6例复发或转移病变均为B2型肿瘤。重症肌无力在A型、AB型、B1型、B2型、B3型和C型肿瘤患者中的发生率分别为0%、6.8%、40.0%、55.6%、10.0%和0%。每克肿瘤组织中肿瘤相关CD4+CD8+细胞的平均数量（×10⁶）在A型、AB型、B1型、B2型、B3型和C型中分别为1.5、391.1、1041.7、333.9、24.5和0.2，在正常胸腺中为1168.2。因此，B1型肿瘤保留了诱导CD4+CD8+双阳性细胞的功能，其水平与正常胸腺皮质上皮细胞相当，其次是AB型和B2型肿瘤。A型和B3型肿瘤的这种功能水平几乎检测不到，C型肿瘤无功能。WHO组织学分类显示能够反映胸腺上皮肿瘤的临床特征和T细胞诱导功能。
