The Relationship Between Tams And The Classification, Invasion And Prognosis In Thymoma.

【Background】Thymus, as an important organ of the human body immunity, is composed of epithelial cells and lymphocytes. Thymoma is from different thymus epithelial cells that have unique characteristics in the anterior mediastinum, presenting with chest pain,dyspnea, coughing and chest discomfort in clinical. In addition, some have complications such as MG, PRCA and hypoglobulinemia. The histopathologic classification of thymoma was significant for diagnosis and prognosis. Although there were some outgrowth of the past, no one, however, can better reflect its pathological, clinical and the prognosis of thymoma. In 1999, WHO advanced a new classification, and further amendments in 2004. At present, the method has become the standard scheme.Tumor-associated macrophages (TAMs) are come from peripheral blood with a unique phenotype. TAMs motivate the occurrence, development and infiltration and transformation of tumor cells by secreting some growth factors in tumor micro environment.【Objective】To discuss the relation between TAMs and its clinicopathological characteristics by counting TAMs in thymoma, and to provide a potential new indicator for the pathological diagnosis and evaluation.【Methods】1. Histopathogical subtyping of 95 thymomas by the hematoxylin-eosin staining.2. Immunohistochemistry was used to detect TAMs in 95 examples of thymoma tissues.3. The prognosis data of patient was followed up.4. Statistical test was employed to analyze the relation between TAMs and the clinicopathological parameters In addition, the patients' survival was analyzed by Kaplan-Meier method.【Results】1. CD68 (a biomarker for TAMs) was positive in 95 examples of thymoma tissues;2. The percentage of TAMs indifferent substypes,i.e.B1, B2, B3, C, of thymoma were 2.9%,5.4%,11.9% and 13.2% respectively and A/AB 9.9%. Statistics analysis showed that there were significant differences between the types. (software p<0.05)3. The percentage of TAMs in epithelial-rich, lymphocyte—rich and mixed lymphoepithelial thymomas were 12.7%,2.9%,7.4%, respectively. Statistically, there was a significant difference between them (p<0.05)4. The percentage of TAMs in thymoma, atypical thymoma and thymic carcinoma were 6.8%,11.9%,13.2% respectively, and there were significant differences between them (p<0.05)5. The percentage of TAMs in invasive thymoma was 11.1%, but noninvasive thymoma 5.7%, and Statistically there was significant difference between the two groups..【Conclusions】1. There was close relationship between TAMs numbers and pathological features of thymoma and TAMs count may be an objective biomarker for the pathological diagnosis;2. TAMs counting was useful for assessing survive of the patients after their operation;3. The pathological classification of thymoma (WHO or Suster-Mora classification) was useful for assessing patient survive after their operation;4. Tumor invasion is closely related with patient survive and it could be an objective biomarker;5. There was no correlation of the TAMs numbers with sex, age, the size of tumor and MG. Meanwhile, the latters were not correlated with patient survive.