世界卫生组织胸腺瘤组织学分类的临床实用性。

Clinical usefulness of the WHO histological classification of thymoma.

作者信息

Sonobe Satoshi, Miyamoto Hideaki, Izumi Hiroshi, Nobukawa Bunsei, Futagawa Toshiro, Yamazaki Akio, Oh Tumin, Uekusa Toshimasa, Abe Hiroshi, Suda Koichi

机构信息

Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, and Department of Clinical Laboratory, Labor Welfare Corporation Kanto Rosai Hospital, Kanagawa, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2005 Dec;11(6):367-73.

PMID:16401984

Abstract

PURPOSE

Rosai et al. published the World Health Organization (WHO) classification of thymic epithelial tumors in 1999, and its clinical usefulness seems to be established. It is our purpose to find the clinically relevant diagnostic points in the WHO Histological Classification of Thymoma.

METHODS

Thymomas surgically removed from 100 consecutive patients at Juntendo University Hospital between October 1983 and February 2002 were classified according to the WHO histological classification. We assessed overall survival and recurrence-free rate calculated for each tumor type in the WHO classification compared with those of tumors classified by the Masaoka system.

RESULTS

The thymic epithelial tumors in this series comprised 10 type A, 15 type AB, 18 type B1, 21 type B2, 33 type B3, and 3 type C tumors according to the WHO classification. Based on the Masaoka system, the disease was stage I in 53 patients, stage II in 30, stage III in 15, and stage IV in 2. The 15-year recurrence-free rate was 100% for type A, AB and B1, while the rates for types B2 and B3 were 66.7% and 54.5%, respectively. The 10-year recurrence-free rate was 66.7% for type C. The 15-year recurrence-free rate of the 64 patients with type A, AB, B1, and B2 thymomas was significantly higher from that of the 33 patients with type B3 thymoma (p=0.0026).

CONCLUSION

When using the WHO classification, it is critical to distinguish type B3 thymoma from other tumor types.

摘要

目的

罗萨伊等人于1999年发表了世界卫生组织（WHO）胸腺上皮肿瘤分类，其临床实用性似乎已得到确立。我们的目的是在WHO胸腺瘤组织学分类中找到临床相关的诊断要点。

方法

对1983年10月至2002年2月间在顺天堂大学医院连续100例手术切除的胸腺瘤，按照WHO组织学分类进行分类。我们评估了WHO分类中各肿瘤类型的总生存率和无复发生存率，并与根据马萨oka系统分类的肿瘤进行比较。

结果

根据WHO分类，本系列中的胸腺上皮肿瘤包括10例A型、15例AB型、18例B1型、21例B2型、33例B3型和3例C型肿瘤。根据马萨oka系统，53例患者疾病处于I期，30例处于II期，15例处于III期，2例处于IV期。A型、AB型和B1型的15年无复发生存率为100%，而B2型和B3型分别为66.7%和54.5%。C型的10年无复发生存率为66.7%。64例A型、AB型、B1型和B2型胸腺瘤患者的15年无复发生存率显著高于33例B3型胸腺瘤患者（p = 0.0026）。