Su Xue-Ying, Wu Wei-Lu, Liu Nian, Zhang Shang-Fu, Li Gan-Di
Department of Pathology, West China Hospital of Sichuan University Chengdu, China.
Int J Clin Exp Pathol. 2014 Oct 15;7(11):7760-7. eCollection 2014.
The WHO histological classification for thymic epithelial tumors of 2004 edition is widely used, but its prognostic value is still controversial. In the present study we collected 249 Chinese patients with thymic epithelial tumors from West China Hospital of Sichuan University since 1999-2009 to assess the prognosis relating to tumor stages, histological classifications, MG and adjuvant therapy. There were 18 cases of type A (7.2%), 97 of type AB (39.0%), 22 of type B1 (8.8%), 63 of type B2 (25.3%), 16 of type B3 (6.5%) thymomas and 33 of thymic carcinomas (13.3%). According to the Massaoka staging, there were 107 patients in stage I (43%), 73 patients in stage II (29.3%), 50 patients in stage III (20.1%) and 19 in stage IV (7.6%). 101 patients (40.6%) complicated with MG, the incidence of MG was highest in type B3 thymomas, then in B2, none of thymic carcinomas complicated with MG. Cox regression analysis showed the Masaoka stage was the most important prognostic factor. Besides of staging, WHO histological classification was also an independent prognostic factor. The age, gender, MG and adjuvant therapy have no significant influence to the prognosis of the patients.
世界卫生组织(WHO)2004年版胸腺上皮肿瘤组织学分类应用广泛,但其预后价值仍存在争议。在本研究中,我们收集了1999年至2009年四川大学华西医院249例中国胸腺上皮肿瘤患者,以评估肿瘤分期、组织学分类、重症肌无力(MG)及辅助治疗与预后的关系。其中A型胸腺瘤18例(7.2%),AB型胸腺瘤97例(39.0%),B1型胸腺瘤22例(8.8%),B2型胸腺瘤63例(25.3%),B3型胸腺瘤16例(6.5%),胸腺癌33例(13.3%)。根据Massaoka分期,Ⅰ期患者107例(43%),Ⅱ期患者73例(29.3%),Ⅲ期患者50例(20.1%),Ⅳ期患者19例(7.6%)。101例患者(40.6%)合并MG,MG发生率在B3型胸腺瘤中最高,其次为B2型胸腺瘤,胸腺癌无一例合并MG。Cox回归分析显示,Massaoka分期是最重要的预后因素。除分期外,WHO组织学分类也是独立的预后因素。年龄、性别、MG及辅助治疗对患者预后无显著影响。