WHO histologic classification is a prognostic indicator in thymoma
WHO histologic classification is a prognostic indicator in thymoma
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DOI：
10.1016/j.athoracsur.2003.07.042
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发表时间：
2004-04-01
影响因子：
4.6
通讯作者：
Monden, Y
中科院分区：
文献类型：
--
作者：
Kondo, K;Yoshizawa, K;Monden, Y
背景胸腺瘤的组织学分类多年来一直存在争议。1999年，世界卫生组织共识委员会发表了胸腺肿瘤的组织学分型系统。我们对1973年至2001年在日本德岛大学医院和四家附属医院切除的100例胸腺瘤进行了重新分类，并报告了其临床病理关系和预后相关性。A型8例，AB型17例，B1型27例，B2型8例，B3型12例，C型28例。根据肿瘤亚型，邻近器官的侵袭频率依次增加，A（0%），AB（6%），B1（19%），B2（25%），B3（42%）和C（89%）。A型、AB型和B2型胸腺瘤患者无复发。B1、B3和C型胸腺瘤患者的复发率分别为15%、36%和47%。10年无病生存率：A型和AB型100%，B1型和B2型83%，B3型36%，C型28%。A型和AB型与B1型和B2型之间的无病生存率存在显著差异（p = 0.0436），B3型与C型之间的无病生存率存在显著差异（p = 0.042）。通过多变量分析，只有Masaoka临床分期（p = 0.002）对无病生存率有显著的独立影响。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%。目前的研究证实了世界卫生组织的组织学分类是一个良好的预后因素。
Background. 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.Methods. 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.Results. 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.Conclusions. The current study confirmed the World Health Organization histologic classification as a good prognostic factor.