[82例胸腺瘤患者新组织学分类与其临床特征及预后的相关性]

[Correlations of novel histological classification of 82 thymoma patients to their clinical characteristics and prognosis].

作者信息

Su Xiao-Dong, Rong Tie-Hua, Long Hao, He Jie-Hua, Zhang Lan-Jun, Zhang Xu, Zhao Jin-Ming

机构信息

State Key Laboratory of Oncology in Southern China, Guangzhou, Guangdong, 510060, PR China.

出版信息

Ai Zheng. 2005 Nov;24(11):1363-6.

PMID:16552964

Abstract

BACKGROUND & OBJECTIVE: The World Health Organization (WHO) histological classification of thymoma was published in 1999. This study was to investigate the correlations of WHO histological classification of thymoma to its clinical characteristics and prognosis.

METHODS

Records of 82 thymoma patients treated with surgery were reviewed retrospectively. Histological diagnosis based on WHO classification system was made by an experienced pathologist. The correlations of WHO histological classification of thymoma to its clinical characteristics and prognosis were analyzed.

RESULTS

Of the 82 cases, 5 (6.1%) were type A, 21 (25.6%) were type AB, 14 (17.1%) were type B1, 12 (14.6%) were type B2, 14 (17.1%) were type B3, and 16 (19.5%) were type C; according to Masaoka clinical staging system, 29 (35.4%) were in stage I, 13 (15.8%) in stage II , 32 (39%) in stage III , and 8 (9.8%) in stage IVa. The histological subtype of thymoma was significantly correlated with clinical stage (chi2 = 47.29, P < 0.001) and tumor invasive degree (chi2 = 30.78, P < 0.001). Complete resection rate was significantly higher in patients with type A, AB, B1 or B2 tumors than in patients with type B3 or C tumors (84.6% vs. 50.0%, chi2 = 11.29, P = 0.002). The 5-year survival rates of patients with stage I, II, III , and IVa were 100%, 100%, 69.5%, and 37.5%, respectively; the 10-57.1%, year survival rates were 88.1%, 47.5, and 0, respectively. The difference of survival rates among different clinical stages (log-rank = 40.31, P < 0.001) and histological subtypes (log-rank = 16.0, P = 0.007) were significant.

CONCLUSION

To some extent, the WHO histological classification reflects the biological behavior and clinical characteristics of thymoma, and may be helpful in diagnosing and treating thymoma.

摘要

背景与目的

世界卫生组织（WHO）胸腺肿瘤组织学分类于1999年发布。本研究旨在探讨WHO胸腺肿瘤组织学分类与其临床特征及预后的相关性。

方法

回顾性分析82例接受手术治疗的胸腺肿瘤患者的病历。由经验丰富的病理学家根据WHO分类系统进行组织学诊断。分析WHO胸腺肿瘤组织学分类与其临床特征及预后的相关性。

结果

82例患者中，A型5例（6.1%），AB型21例（25.6%），B1型14例（17.1%），B2型12例（14.6%），B3型14例（17.1%），C型16例（19.5%）；根据Masaoka临床分期系统，Ⅰ期29例（35.4%），Ⅱ期13例（15.8%），Ⅲ期32例（39%），Ⅳa期8例（9.8%）。胸腺肿瘤的组织学亚型与临床分期（χ2 = 47.29，P < 0.001）及肿瘤浸润程度（χ2 = 30.78，P < 0.001）显著相关。A型、AB型、B1型或B2型肿瘤患者的完整切除率显著高于B3型或C型肿瘤患者（84.6%对50.0%，χ2 = 11.29，P = 0.002）。Ⅰ期、Ⅱ期、Ⅲ期和Ⅳa期患者的5年生存率分别为100%、100%、69.5%和37.5%；10年生存率分别为88.1%、47.5%和0。不同临床分期（log-rank = 40.31，P < 0.001）和组织学亚型（log-rank = 16.0，P = 0.007）的生存率差异显著。