胸腺瘤组织学分型与重症肌无力及临床分期关系

目的探讨胸腺瘤最新WHO病理分型与重症肌无力(MG)及临床分期之间的关系。方法回顾分析1980-2004年间74例因胸腺瘤行胸腺切除的患者,运用最新WHO分型标准(1999)对胸腺瘤进行重新分类,并运用统计软件对新的WHO组织学分型与MG的发生率及Masaoka临床分期之间的关系做进一步分析。结果(1)胸腺瘤A型2例,AB型23例,B1型4例,B2型27例,B3型16例,C型2例。其中B2型较AB、B1及B3型易合并MG(P<0.05),A型两例均合并MG,而C型则均未合并MG。(2)临床I期:1例,Ⅱ期:30例,Ⅲ期:38例,Ⅳ期:5例。新的WHO组织学分型与Masaoka分期之间关系密切(P<0.01)。结论新WHO组织学分型与胸腺瘤合并MG的发生率之间有一定关系,同时能反映其临床分期及评价患者的预后。     

胸腺瘤WHO组织学分型、Masaoka临床分期和预后的关系

目的 探讨胸腺瘤WHO组织学分型与Masaoka分期和预后的相关性。方法 回顾性分析65例胸腺瘤患者的临床资料，经有经验的病理科医生按WHO组织学分型标准重新分类，并结合患者的Masaoka分期和预后进行分析。结果 胸腺瘤A型8例，AB型10例，B1型8例，B2型17例，B3型15例，C型7例，5年生存率分别为：100％，100％，92．6％，82．4％，54．5％，57．8％。Masaoka临床分期，Ⅰ期20例，Ⅱ期18例，Ⅲ期16例，Ⅳ期11例；5年生存率分别为100％，100％，68．6％和35．7％。组织学分型与临床分期的相关性有显著性意义（χ^2=39．47，P=0．001）。各组织学分型间生存率的差异（Log-rank=17．17，P=0．004）与不同临床分期间生存率的差异（Log-rank=44．93，P〈0．001）均有统计学意义。结论 WHO组织学分型与Masaoka分期存在相关性，二者对于评估胸腺瘤的预后均具有重要参考价值，并提示根治性手术治疗是患者获得长期生存的关键。     

胸腺瘤组织学分型与重症肌无力及临床分期关系

目的:探讨胸腺瘤最新WHO病理分型与重症肌无力(MG)及临床分期之间的关系。方法:回顾分析1980~2004年间 74例因胸腺瘤行胸腺切除的患者,运用最新WHO分型标准 (1999)对胸腺瘤进行重新分类,并运用统计软件对新的WHO组织学分型与MG的发生率及Masaoka临床分期之间的关系做进一步分析。结果:①胸腺瘤A型 2例,AB型 23例,B1型 4例,B2型 27例,B3型 16例,C型 2例。其中B2型较AB、B1及B3型易合并MG(P<0. 05),A型两例均合并MG,而C型则均未合并MG。②临床Ⅰ期: 1例,Ⅱ期: 30例,Ⅲ期: 38例,Ⅳ期: 5例。新的WHO组织学分型与Masaoka分期之间关系密切(P<0. 01)。结论:新WHO组织学分型与胸腺瘤合并MG的发生率之间有一定关系,同时能反映其临床分期及评价患者的预后。     

胸腺瘤组织学分型与重症肌无力及临床分期关系(英文)

目的探讨胸腺瘤最新 WHO 病理分型与重症肌无力(MG)及临床分期之间的关系。方法回顾分析1980～2004年间74例因胸腺瘤行胸腺切除的患者,运用最新 WHO 分型标准(1999)对胸腺瘤进行重新分类,并运用统计软件对新的 WHO 组织学分型与 MG 的发生率及 Masaoka 临床分期之间的关系做进一步分析。结果 (1)胸腺瘤 A 型2例,AB 型23例,B1型4例,B2型27例,B3型16例,C 型2例。其中 B2型较 AB、B1及 B3型易合并 MG(P<0.05),A 型两例均合并 MG,而 C 型则均未合并 MG。(2)临床Ⅰ期:1例,Ⅱ期:30例,Ⅲ期:38例,Ⅳ期:5例。新的 WHO 组织学分型与 Masaoka 分期之间关系密切(P<0.01)。结论新 WHO 组织学分型与胸腺瘤合并 MG 的发生率之间有一定关系,同时能反映其临床分期及评价患者的预后。     

胸腺上皮肿瘤89例临床分析

背景与目的:胸腺上皮肿瘤(thymic epithelial tumors,TET)是前纵隔最常见的肿瘤之一,临床上通常根据Masaoka分期及WHO组织学分型判定其良、恶性.本文通过对89例TET患者进行临床分析,探讨WHO组织学分型与Masaoka分期之间的相关性,研究不同分期、分型TET的手术特点及预后影响因素.方法:分析1999年3月～2009年6月经手术确诊的89例TET患者的临床资料,并进行随访,分析TET Masaoka分期、WHO组织学分型及手术切除情况与生存率之间的关系.结果:本组Masaoka分期:I期39例(43.8%),Ⅱ期15例(16.9%),Ⅲ期31例(34.8%),Ⅳa期4例(4.5%),无Ⅳb期患者;其5年生存率分别为I期100%;Ⅱ期92.9%;Ⅲ期62.1%;Ⅳ期25.0%o WHO组织学分型:A型7例(7.9%),AB型16例(18.0%),Bl型13例(14.6%),B2型18例(20.2%),B3型13例(14.6%),C型22例(24.7%);其5年生存率分别为100%,100%,100%,94.1%,80.0%和54.5%.手术完全切除69例(86.3%),不完全切除或活检11例(13.8%),其5年生存率分别为92.8%和9.1%0Masaoka分期、WHO组织学分型、手术切除的完整性是影响患者预后的独立预测因素.结论:WHO组织学分型与Masaoka分期有高度相关性(P=0.000),两者皆可指导临床治疗.手术完全切除是TET最主要的治疗方法.     

合并重症肌无力的胸腺瘤患者术后生存的初步分析--ChART数据库回顾性结果

背景与目的重症肌无力（myasthenia gravis, MG）对胸腺瘤患者预后的影响至今尚不明确,本文旨在比较单纯胸腺瘤与合并肌无力胸腺瘤患者的手术预后。方法1992年至2012年中国胸腺协作组（Chinese Alliance for Research in hTymomas, ChART）数据库录入的18个胸外科中心诊断胸腺瘤并接受相关手术的患者分为合并重症肌无力组（合并组）和单纯胸腺瘤组（对照组）。收集两组患者的人口学资料及临床资料,比较两组患者生存率。结果共1,850例患者纳入研究,其中合并肌无力组及单纯胸腺瘤组分别421人和1429人,行胸腺全切的比例分别是91.2%和71.0%（P<0.05）;肌无力组患者的WHO病理类型多分布于AB、B1和B2型,优于单纯胸腺瘤组（P<0.05）;合并肌无力组的Masaoka分期较早（I和II期）的比例高于单纯胸腺瘤组。5年和10年的总体生存率在MG组和非MG组中分别为93%和88%;83%和81%（P=0.034）;在Masaoka III、IVa和IVb期胸腺瘤患者中,合并肌无力患者的生存曲线高于单纯胸腺瘤患者（P=0.003）。在进展型胸腺瘤患者中,MG组和非MG组患者的Masaoka III、IVa、IVb的构成比相似,组织学结果中,MG组的AB/B1/B2/B3型的比例高于C型比例更高的非MG组（P<0.001）。整体的单因素分析结果提示,MG、WHO分型、Masaoka分期、手术方式、化疗、放疗和临床切除状况均为预后的影响因素。而在多因素分析中,WHO分型、Masaoka分期和临床切除状况是独立的预后预测指标。结论虽然重症肌无力不是独立的预后影响因素,但是在胸腺瘤患者中,合并MG的患者预后较优,尤其是Masaoka分期晚期的患者,可能与疾病的早期发现、病理类型分布相对较好、整体R0切除率较高以及复发率较低有关。     

恶性胸腺瘤预后因素分析

目的:探讨影响恶性胸腺瘤患者术后生存率的相关因素.方法:分析72例恶性胸腺瘤的临床特点,运用Kaplan-Meirer法计算生存率,应用Log-rank法和COX比例风险模型对可能影响胸腺瘤术后生存率的因素进行单因素和多因素分析.结果:全组患者1、3、5年生存率为74.08%、55.60%、44.66%.单因素分析显示手术切口、大血管的累及、WHO组织学分类、Masaoka分期对恶性胸腺瘤患者术后生存率具有影响(P＜0.05),多因素分析表明仅Masaoka分期、WHO组织学分类、大血管的累及是独立的预后因素.结论:恶性胸腺瘤应采用手术为主的综合治疗,Masaoka分期、WHO组织学分类、大血管的累及是影响预后的独立因素.     

胸腺瘤术后患者预后营养指数与总生存率的相关性

目的 探讨预后营养指数(PNI)与胸腺瘤术后患者总生存率的相关性.方法 回顾性分析173例胸腺瘤术后患者的临床病理资料.结果 手术是否R0切除(P<0.001)、是否合并重症肌无力(P<0.001)、Masaoka分期(Ⅱ/Ⅰ:P=0.012;Ⅲ&Ⅳ/Ⅰ:P=0.011)、WHO分型(P<0.001)和PNI(P=0....     

胸腺瘤239例预后相关因素分析

目的 胸腺瘤是最常见的纵隔肿瘤之一,占纵隔肿瘤的20％～40％.本研究探讨影响胸腺瘤预后的相关因素.方法 对广西医科大学附属肿瘤医院1985-10-01-2012-11-30收治的经病理确诊的378例胸腺瘤患者临床资料进行回顾性分析,对原病理类型按2004年世界卫生组织(World Health Organization,WHO)分型标准重新分型,随访239例患者,生存率的计算及单因素生存分析采用Kaplan-Meier法进行,其间差异性使用Log-rank检验进行计算,所有经单因素生存分析有意义的参数均纳入多因素生存分析Cox回归模型进行计算.结果 随访239例患者,单因素分析结果显示,年龄、有无临床症状、肿瘤切除范围、是否侵犯大血管、WHO组织学分类和Masaoka分期对胸腺瘤患者预后有显著性影响.Cox模型多因素分析显示,肿瘤切除范围(HR=3.25,95％CI:1.747～2.322,P＜0.000 4)、是否侵犯大血管(HR=5.28,95％CI:2.368～10.681,P＜0.000 1)、WHO分型(HR=1.836,95％CI:1.253～3.192,P＜0.005 6)和Masaoka分期(HR=3.129,95％CI:1.964～5.83,P＜0.001 2)是影响胸腺瘤患者远期生存率的独立因素.是否合并重症肌无力对胸腺瘤预后无影响.结论 WHO组织分型、Masaoka分期、肿瘤切除范围和是否侵犯大血管是影响胸腺瘤患者预后的独立因素.     

126例胸腺瘤伴重症肌无力患者临床特点及预后

目的 探讨胸腺瘤伴重症肌无力患者的临床特点及预后。方法 回顾分析2008—2014年经术后病理证实的126例胸腺瘤伴重症肌无力患者的临床病理资料。Kaplan-Meier法计算生存率,Logrank法单因素预后分析,Cox法多因素预后分析。结果 全组3、5年样本量分别为88例、45例。3、5年生存率分别为97.9%、91.8%。WHO分型中A+AB+B1+B2型与B3型患者3、5年生存率分别为98.6%与95.2%、90.6%与92.9%(P=0.764)。Masaoka分期Ⅰ+Ⅱ期与Ⅲ+Ⅳ期患者3、5年生存率分别为98.6%与95.2%、97.4%与72.7%(P=0.791)。完整切除与部分切除患者3、5年生存率分别为97.8%与91.7%、100.0%与50.0%(P=0.964)。单纯完整切除与完整切除+术后放疗患者3、5年生存率分别为96.8%与93.1%、100.0%与94.7%(P=1.000)。结论 胸腺瘤伴重症肌无力患者应尽可能行完整手术切除,术后根据具体情况给予放疗。完整切除、术后放疗、WHO分型、Masaoka分期可能与预后有关。     

Association of clinical and pathological variables with survival in thymoma

Our aim was to evaluate clinical and pathological features in prognosis of thymoma patients with particular emphasis on patients with myasthenia gravis (MG). From 1995 to 2010, 140 thymoma patients (women/men: 63/77) with a median age of 46 years (11-80 years) were admitted to our institution. According to World Health Organization (WHO), there were 23 (17%) type A, 12 (9%) type AB, 24 (17%) type B1, 42 (31%) type B2 and 36 (26%) type B3. The distribution of Masaoka stages I, II, III and IV was 24 (17%), 71 (51%), 18 (13%) and 27 (19%), respectively. MG coexisted in 61% of patients. After a mean follow-up of 34 months (1-158 months), 102 (73%) patients are alive and well while 14 (10%) are alive with disease. Twenty-three patients (16%) have died, only 9 died of thymoma. In univariate analyses, completeness of resection (P < .001), WHO histology (P = .008), Masaoka stage (P < .001) and MG (P = .002) were significant prognostic factors for progression-free survival (PFS). Young age (P = .008); Masaoka stages 1 and 2 (P = .039); WHO types A, AB and B1 (P = .031); complete resection (P = .024) and presence of MG (P = .05) significantly correlated with overall survival (OS). In multivariate analysis, Masaoka stages 1 and 2 (P = .038) and presence of MG (P = .01) were significantly correlated with a longer PFS; MG (P = .021) and WHO subtype (P = .022) were found to be significant prognostic factors for OS. Adjuvant radiotherapy improved neither OS nor PFS in completely resected stage 2 thymoma. Masaoka staging, WHO and MG are major determinants of prognosis in Turkish thymoma patients. Additionally, radiotherapy did not provide survival advantage to stage 2 patients with complete resection.     

New WHO histologic classification predicts prognosis of thymic epithelial tumors: a clinicopathologic study of 200 thymoma cases from China

BACKGROUND: In 1999, a World Health Organization (WHO) committee published histologic criteria for distinct thymoma entities (labeled as Type A, AB, B1, B2, B3 thymomas) and for the heterogeneous group of thymic carcinomas, collectively called Type C thymomas. Whether WHO-defined histologic thymoma subtypes are of independent prognostic relevance has yet to be proved. METHODS: Two hundred thymomas from the Shanghai Chest Hospital with a mean follow-up time of 15 years (range, 1-246 months) were studied for the relevance of WHO histologic subtype and other factors (stage, therapy, and myasthenia gravis [MG]) for survival. RESULTS: In order of frequency, 68 patients (34.0%) had Type AB, 39 (19.5%) had Type B2, 36 (18.0%) had Type C, 27 (13.5%) had Type B3, 17 (8.5%) had Type B1, and 8 (4.0%) had Type A thymoma. Five cases (2.5%) were rare thymomas not mentioned in the WHO classification. Survival data showed significant differences among the histologic subtypes (log rank test: P < 0.001). Among patients with Type A and AB thymomas, none died of tumor; of the Type B1 thymoma patients, only one (5.9%) died at 22 months. Type B2, B3, and C thymomas had a significantly worse prognosis with 5-year survival rates of 75.0%, 70.0%, and 48.0%, respectively. Ninety-six patients (48.0%) were in Masaoka Stage I, 26 (13.0%) were in Stage II, 65 (32.5%) were in Stage III, and 13 (6.5%) were in Stage IV. Stage was highly significant in predicting survival (log rank, test P < 0.001). The association between histologic subtype and invasive behavior (stage) was statistically significant (P < 0.001). However, histology was an independent predictive factor of survival in Stage I and II thymomas: Type B2, B3, and C thymomas had a worse prognosis than Type A, AB, and B1 thymomas (log rank test: P < 0.003). Thirty patients (15.0%) presented with MG. MG was significantly more frequent in Type B2 and B3 than in Type A, AB, and B1 thymomas (P < 0.01). On multivariate analysis, MG had no adverse effect on survival (P = 0.17). Radiation or chemotherapy improved patients' survival at 5 and 10 years in Type B2, B3, and C thymomas (log rank test: P < 0.003). CONCLUSIONS: Tumor stage is the most important determinant of survival in thymoma patients, but the WHO histologic subtype is an independent prognostic factor in Stage I and II thymomas, among which WHO Type A, AB, and B1 thymomas form a low-risk group. Patients with high-risk thymomas might profit from novel adjuvant radiochemotherapy regimens.     

The World Health Organization histologic classification system reflects the oncologic behavior of thymoma: a clinical study of 273 patients

BACKGROUND: Although the histologic classification of thymic epithelial tumors has been confusing and controversial, an agreement on the universal classification system for thymic epithelial tumors was achieved by the World Health Organization (WHO) in 1999. The authors previously reported that the WHO histologic classification system reflects invasiveness and immunologic function of thymic epithelial tumors. In this subsequent study, they examined the prognostic significance of this classification system. METHODS: Clinical features as well as postoperative survival of patients with thymoma, but not thymic carcinoma, were examined with reference to WHO histologic classification based on an experience with 273 patients over a 44-year period. RESULTS: There were 18 type A tumors, 77 type AB tumors, 55 type B1 tumors, 97 type B2 tumors, and 26 type B3 tumors. In patients with type A, AB, B1, B2, and B3 tumors, the respective proportions of invasive tumor were 11.1%, 41.6%, 47.3%, 69.1%, and 84.6%; the respective proportions of tumors with involvement of the great vessels were 0%, 3.9%, 7.3%, 17.5%, and 19.2%; and the respective 20-year survival rates were 100%, 87%, 91%, 59%, and 36%. According to the Masaoka staging system, the 20-year survival rates were 89%, 91%, 49%, 0%, and 0% in patients with Stage I, II, III, IVa, and IVb disease, respectively. By multivariate analysis, the Masaoka staging system and the WHO histologic classification system were significant independent prognostic factors, whereas age, gender, association with myasthenia gravis, completeness of resection, or involvement of the great vessels were not significant independent prognostic factors. CONCLUSIONS: This study showed that histologic appearance reflects the oncologic behavior of thymoma when the WHO classification system is adopted. The WHO classification system may be helpful in clinical practice for the assessment and treatment of patients with thymoma.     

Surgical outcomes and reevaluation of treatment strategies for thymomas

Improved histological typing systems for thymic tumors and advances in induction and adjuvant therapy have created the need to reevaluate strategies for the management of thymoma. We retrospectively studied 73 patients with completely resected thymomas unassociated with myasthenia gravis. The World Health Organization (WHO) histologic classification, clinicopathological features and surgical outcomes were analyzed. Overall survival was 66.2% at 10 years, and the median survival time was 169 months. According to the Masaoka staging system, overall survival rates at 10 years were 94.7% in stage I, 76.1% in stage II, 30% in stage III and 0% in stage IV. In the WHO classification, overall survival rates at 10 years were 91.9% in types A and AB, 50.9% in type B2 and not achieved in type B3. The disease-free interval was slightly shorter in patients with B2 and B3 disease than in those with type A, AB and B1 disease. Advanced thymomas were significantly associated with type B2 and B3 (p<0.01). In stage III and IV disease, adjuvant or neoadjuvant therapy was associated with better survival as compared to no adjuvant therapy (p=0.07). On multivariate analysis, Masaoka stage III and IV disease and extended thymectomy indicated significant, negative and independent risk factors for survival (p<0.01). Masaoka stage I and II thymomas or WHO type A and AB thymomas have favorable prognoses and do not require postoperative adjuvant therapy. Patients with stage III and IV thymomas require additional therapy after surgery.     

Long-term outcomes of 307 patients after complete thymoma resection

Background: Thymoma is an uncommon tumor without a widely accepted standard care to date. We aimed to investigate the clinicopathologic variables of patients with thymoma and identify possible predictors of survival and recurrence after initial resection. Methods: We retrospectively selected 307 patients with thymoma who underwent complete resection at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (Beijing, China) between January 2003 and December 2014. The associations of patients' clinical characteristics with prognosis were estimated using Cox regression and Kaplan–Meier survival analyses. Results: During follow-up (median, 86 months; range, 24–160 months), the 5- and 10-year disease-free survival (DFS) rates were 84.0% and 73.0%, respectively, and the 5- and 10-year overall survival (OS) rates were 91.0% and 74.0%, respectively. Masaoka stage (P < 0.001), World Health Organization (WHO) histological classification (P < 0.001), and postoperative radiotherapy after initial resection (P = 0.006) were associated with recurrence (52/307, 16.9%). Multivariate analysis revealed that, after initial resection, WHO histological classification and Masaoka stage were independent predictors of DFS and OS. The pleura (25/52, 48.0%) were the most common site of recurrence, and locoregional recurrence (41/52, 79.0%) was the most common recurrence pattern. The recurrence pattern was an independent predictor of post-recurrence survival. Patients with recurrent thymoma who underwent repeated resec-tion had increased post-recurrence survival rates compared with those who underwent therapies other than surgery (P = 0.017). Conclusions: Masaoka stage and WHO histological classification were independent prognostic factors of thymoma after initial complete resection. The recurrence pattern was an independent predictor of post-recurrence survival. Locoregional recurrence and repeated resection of the recurrent tumor were associated with favorable prognosis.     

Assessment of the ITMIG Statement on the WHO Histological Classification and of the Eighth TNM Staging of Thymic Epithelial Tumors of a Series of 188 Thymic Epithelial Tumors

IntroductionThymic epithelial tumors (TETs) are rare intrathoracic malignancies that are categorized histologically according to the WHO classification, which was recently updated in 2015 on the basis of a consensus statement of the International Thymic Malignancy Interest Group (ITMIG); at the same time, the standard Masaoka-Koga staging system is scheduled to be replaced by the eighth edition of the TNM staging classification by the American Joint Committee on Cancer/Union for International Cancer Control consortium. Our objectives were to analyze the feasibility of assessing ITMIG consensus major and minor morphological and immunohistochemical criteria and the eighth edition of the TNM staging classification in a routine practice setting.MethodsThis is a single-center study conducted at the Louis-Pradel Hospital of Lyon University, one of the largest centers for TETs in France. Overall, a large surgical series of 188 TETs diagnosed in 181 patients between 2000 and 2014 at our center were analyzed.ResultsThere were 89 men (49%) and 92 women (51%); 57 patients (31%) presented with myasthenia gravis at time of diagnosis. According to the WHO classification, there were nine type A thymomas (5%), 67 type AB thymomas (36%), 19 type B1 thymomas (10%), 46 type B2 thymomas (24%), 27 type B3 thymomas (14%), and 20 thymic carcinomas (11%). ITMIG consensus major criteria were identified in 100% of type A, AB, B1, and B2 thymomas. After restaging according to the eighth edition of the TNM staging classification, there were 127 stage I (84%), three stage II (2%), 17 stage IIIa (11%), no stage IIIb, two stage IVa (1%), and three stage IVb (2%) thymomas. Significant correlation between histological type and stage at diagnosis was maintained after restaging according the TNM classification.ConclusionComprehensive analysis of our well-characterized surgical series of 188 TETs indicates the feasibility and the diagnostic value of the ITMIG consensus statement on WHO histological classification and highlights the major switch in staging when the eighth edition of the TNM staging classification is applied.     

Gene expression analysis of human thymoma correlates with tumor stage

Thymoma is one of the most common solid tumors in the mediastinum. The recent development of high-density oligonucleotide arrays provides a unique opportunity to generate gene expression profiles of cells from various stages of tumor progression as it occurs in actual neoplastic tissues. We used oligonucleotide arrays to monitor in vivo gene expression levels in early- (stage I or II) and late- (stage IVa) stage thymoma tissues in 36 patients. These in vivo gene expression profiles were verified by real-time quantitative RT-PCR using LightCycler. Using both methods, 2 candidate genes were identified that were more highly expressed in advanced-stage thymomas. One was a well-known gene, c-JUN, and another was an unknown gene, AL050002. AL050002 expression, but not c-JUN expression, was also correlated with the WHO classification (type B3 vs. type B1, B2 or AB). The combined use of oligonucleotide microarray and real-time RT-PCR analyses provides a powerful new approach to elucidate the in vivo molecular events correlated with tumor stage of thymoma.     

术前病理学诊断在胸腺肿瘤诊疗中的应用

背景与目的探讨术前病理学诊断在胸腺肿瘤诊断和治疗中的价值及其对胸腺肿瘤治疗的影响。方法对中国胸腺肿瘤协作组（Chinese Alliance for Research in hTymomas, ChART）收集的1994年-2012年的多中心且具有明确活检状态的胸腺肿瘤患者的临床病理资料进行回顾性分析,探讨术前病理学诊断的应用趋势及其对胸腺肿瘤患者预后的影响。结果1,902例胸腺肿瘤患者中,术前病理学诊断患者336例（17.1%）。近年来术前病理学诊断的比例较前明显增加（P=0.008）,胸腔镜/纵隔镜/超声内镜下经支气管活检（endobronchial ultrasound, E-BUS）比例较前升高（P=0.029）。术前行病理学诊断患者的生存明显差于无病理学诊断患者（P<0.001）,术前病理学诊断后的目的与肿瘤的Masaoka分期（P<0.001）、切除程度（P=0.025）、病理类型（P<0.001）具有相关性。术前病理学诊断后直接手术患者的生存要明显优于诱导治疗后再手术患者（P<0.001）。结论胸腺瘤诊断主要依靠临床及组织学判断,近年来术前病理学诊断在胸腺肿瘤的诊断和治疗中起重要作用;根治性手术切除是胸腺肿瘤的首先治疗手段;术前病理学诊断后直接手术患者的预后要明显优于诱导治疗后患者。