Kondo Kazuya, Yoshizawa Kiyoshi, Tsuyuguchi Masaru, Kimura Suguru, Sumitomo Masayuki, Morita Junji, Miyoshi Takanori, Sakiyama Shoji, Mukai Kiyoshi, Monden Yasumasa
Department of Oncological and Regenerative Surgery, School of Medicine, University of Tokushima, Tokushima, Japan.
Ann Thorac Surg. 2004 Apr;77(4):1183-8. doi: 10.1016/j.athoracsur.2003.07.042.
The histologic classification of thymoma has remained a subject of controversy for many years. In 1999, the World Health Organization Consensus Committee published a histologic typing system for tumors of the thymus.
We reclassified a series of 100 thymomas resected at Tokushima University Hospital and four affiliated hospitals in Japan between 1973 and 2001 according to the World Health Organization histologic classification and reported its clinicopathologic relationship and prognostic relevance.
There were 8 type A, 17 type AB, 27 type B1, 8 type B2, 12 type B3, and 28 type C thymomas. The frequency of invasion to neighboring organs increased according to tumor subtype in the order A (0%), AB (6%), B1 (19%), B2 (25%), B3 (42%), and C (89%). There was no recurrence in patients with type A, AB, or B2 thymoma. The recurrence rates of patients with B1, B3, or C thymoma were 15%, 36%, and 47%, respectively. The disease-free survival rates were 100% for types A and AB, 83% for types B1 and B2, 36% for type B3, and 28% for type C thymoma at 10 years. There were significant differences in disease-free survival between types A and AB and types B1 and B2 (p = 0.0436), and between type B3 and type C (p = 0.042). By multivariate analysis, only Masaoka clinical stage (p = 0.002) showed significant independent effects on disease-free survival. The 10-year survival rates of types A and AB, types B1 and B2, type B3, and type C thymoma were 100%, 94%, 92%, and 58%, respectively.
The current study confirmed the World Health Organization histologic classification as a good prognostic factor.
多年来，胸腺瘤的组织学分类一直存在争议。1999年，世界卫生组织共识委员会发布了胸腺肿瘤的组织学分型系统。
我们根据世界卫生组织组织学分类，对1973年至2001年间在德岛大学医院及日本四家附属医院切除的100例胸腺瘤进行重新分类，并报告其临床病理关系及预后相关性。
有8例A型、17例AB型、27例B1型、8例B2型、12例B3型和28例C型胸腺瘤。邻近器官受侵频率随肿瘤亚型增加，顺序为A（0%）、AB（6%）、B1（19%）、B2（25%）、B3（42%）和C（89%）。A型、AB型或B2型胸腺瘤患者无复发。B1型、B3型或C型胸腺瘤患者的复发率分别为15%、36%和47%。10年时，A型和AB型胸腺瘤的无病生存率为100%，B1型和B2型为83%，B3型为36%，C型为28%。A型和AB型与B1型和B2型之间的无病生存率有显著差异（p = 0.0436），B3型和C型之间也有显著差异（p = 0.042）。多因素分析显示，仅Masaoka临床分期（p = 0.002）对无病生存有显著独立影响。A型和AB型、B1型和B2型、B3型和C型胸腺瘤的10年生存率分别为100%、94%、92%和58%。
本研究证实世界卫生组织组织学分类是一个良好的预后因素。
