Thymoma: a clinicopathological correlation of 1470 cases
Thymoma: a clinicopathological correlation of 1470 cases
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DOI：
10.1016/j.humpath.2017.08.018
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发表时间：
2018-03-01
期刊：
影响因子：
3.3
通讯作者：
Moran, Cesar A.
中科院分区：
文献类型：
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作者：
Weissferdt, Annikka;Kalhor, Neda;Moran, Cesar A.
我们展示了来自 11 个国家 14 个机构的病理档案中确定的 1470 例胸腺瘤手术切除病例，目的是确定胸腺瘤的简化组织学分类和病理分期与临床结果并将其关联起来。研究人群由 720 名男性和 750 名女性组成，年龄在 12 岁至 86 岁之间（平均 54.8 岁）。临床上，137 名患者（17%）有重症肌无力病史，31 名患者（3.8%）有其他自身免疫性疾病病史，55 名患者（6.8%）有其他肿瘤过程。所有患者均接受手术切除。组织学上，1284例（87.13%）为胸腺瘤（世界卫生组织A、B1和B2型，以及混合组织学），186例（12.7%）为非典型胸腺瘤（世界卫生组织B3型）。全组中，630例（42.9%）为包膜性胸腺瘤，840例（57.9%）为不同阶段的侵袭性胸腺瘤。获得了 1339 名 (91%) 患者的随访信息，随后对这些患者进行了单变量和多变量统计分析。随访时间为 1 至 384 个月（平均 69.2 个月），结果显示 136 名患者（10.1%）肿瘤复发，227 名患者死亡：64 名患者（28.2%）死于肿瘤，163 名患者（71.8%）死于其他原因。统计分析表明，将这些肿瘤分为胸腺瘤和非典型胸腺瘤具有统计学意义（P = .001），而将肿瘤分期为有包膜、微创和侵入邻近器官类别提供了有意义的临床评估，P = .038。我们的研究结果表明，我们简化的组织学图式和病理分期系统是临床结果的极好预测因子。 (C) 2017 Elsevier Inc. 保留所有权利。
We present 1470 surgical resections for thymoma identified in the pathology files of 14 institutions from 11 countries with the purpose of determining and correlating a simplified histological classification of thymoma and pathological staging with clinical outcome. The study population was composed of 720 men and 750 women between the ages of 12 and 86 years (average, 54.8 years). Clinically, 137 patients (17%) had a history of myasthenia gravis, 31 patients (3.8%) of other autoimmune disease, and 55 (6.8%) patients of another neoplastic process. Surgical resection was performed in all patients. Histologically, 1284 (87.13%) cases were thymomas (World Health Organization types A, B1, and B2, and mixed histologies), and 186 (12.7%) were atypical thymomas (World Health Organization type B3). Of the entire group, 630 (42.9%) were encapsulated thymomas, and 840 (57.9%) were invasive thymomas in different stages. Follow-up information was obtained in 1339 (91%) patients, who subsequently were analyzed by univariate and multivariate statistical analysis. Follow-up ranging from 1 to 384 months was obtained (mean, 69.2 months) showing tumor recurrence in 136 patients (10.1%), whereas 227 died: 64 (28.2%) due to tumor and 163 (71.8%) due to other causes. Statistical analysis shows that separation of these tumors into thymoma and atypical thymoma is statistically significant (P = .001), whereas tumor staging into categories of encapsulated, minimally invasive, and invasion into adjacent organs offers a meaningful clinical assessment with a P = .038. Our findings suggest that our simplified histological schema and pathological staging system are excellent predictors of clinical outcome. (C) 2017 Elsevier Inc. All rights reserved.