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BMC Cancer Sep 2020Role of biomarkers for promotion of tumor proliferation (BPTPs) and for promotion of apoptosis (BPAs) in thymic malignant tumors is still unclear. The purpose of this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Role of biomarkers for promotion of tumor proliferation (BPTPs) and for promotion of apoptosis (BPAs) in thymic malignant tumors is still unclear. The purpose of this study was to evaluate the relationship between BPTPs and/or BPAs and malignancy of thymic malignant tumors.
METHODS
Studies on thymic malignant tumors and biomarkers were searched in PubMed, ISI Web of Knowledge, and Embase databases, and all statistical analyses were conducted using Review Manager.
RESULTS
Twelve articles related to biomarkers and thymic malignant tumors were selected and analyzed. A relationship between BPAs and Masaoka stage was demonstrated for four markers, namely Bax, p73, Casp-9 and Bcl-2, included 138 stage I/II patients and 74 stage III/IV patients, and BPAs were significantly correlated with high Masaoka staging (P = 0.03). We further found a relationship between BPAs and degree of malignancy for four markers, namely Bax, p73, Casp-9 and Bcl-2, included 176 thymoma patients and 36 thymic carcinoma patients, and BPAs were significantly correlated with thymic carcinoma (P = 0.010). In addition, a relationship between BPTP and Masaoka staging was demonstrated for seven markers, namely Podoplanin, Glut-1, Muc-1, Egfr, Igf1r, c-Jun, and n-Ras, included 373 patients with stage I/II and 212 patients with stage III/IV, and BPTPs were significantly correlated with high Masaoka staging (P < 0.001). We also found a relationship between BPTPs and degree of malignancy for ten markers, namely Mesothelin, c-Kit (CD117), Egfr, Lat-1, Muc-1,Ema, Glut-1, Igf1r, c-Jun, and n-Ras, included 748 thymoma patients and 280 thymic carcinoma patients, and BPTPs were significantly correlated with thymic carcinoma (P < 0.001).
CONCLUSION
These findings show that high levels of BPTPs or BPAs are more closely related to thymic carcinoma and Masaoka stage III/IV, suggesting that BPTPs and BPAs may play an important role in the occurrence and development of thymic malignant tumors.
Topics: Adult; Aged; Apoptosis; Biomarkers, Tumor; Caspase 9; Cell Proliferation; Female; Humans; Male; Middle Aged; Neoplasm Staging; Proto-Oncogene Proteins c-bcl-2; Thymoma; Thymus Neoplasms; Tumor Protein p73; bcl-2-Associated X Protein
PubMed: 32993581
DOI: 10.1186/s12885-020-07332-z -
Cancer Control : Journal of the Moffitt... 2019The aim of the study was to evaluate the usefulness of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating thymoma from nonthymoma... (Comparative Study)
Comparative Study
The aim of the study was to evaluate the usefulness of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating thymoma from nonthymoma abnormalities in patients with myasthenia gravis (MG). A cross-sectional study of 53 patients with MG, who had undergone surgical thymectomy, was conducted at 103 Hospital (Hanoi, Vietnam) and Cho Ray Hospital (Ho Chi Minh City, Vietnam) during August 2014 and January 2017. The CT and MRI images of patients with MG were qualitatively and quantitatively (radiodensity and chemical shift ratio [CSR]) analyzed to determine and compare their ability to distinguish thymoma from nonthymoma abnormalities. Logistic regression was used to identify the association between imaging parameters (eg, CSR) and the thymoma status. The receiver operating curve (ROC) analysis was used to determine the differentiating ability of CSR and radiodensity. As results, of the 53 patients with MG, 33 were with thymoma and 20 were with nonthymoma abnormalities. At qualitative assessment, MRI had significantly higher accuracy than did CT in differentiating thymoma from nonthymoma abnormalities (94.3% vs 83%). At quantitative assessment, both the radiodensity and CSR were significantly higher for thymoma compared with nonthymoma groups ( < .001). The ROC analysis showed that CSR had significantly higher sensitivity (Se) and specificity (Sp) than radiodensity in discriminating between the 2 groups (CSR: Se 100%, Sp 95% vs radiodensity: Se 90.9%, Sp 70%). When combining both qualitative and quantitative parameters, MRI had even higher accuracy than did CT in thymoma diagnosis ( = .031). In conclusion, chemical shift MRI was more accurate than CT for differentiating thymoma from nonthymoma in patients with MG.
Topics: Adult; Cross-Sectional Studies; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Myasthenia Gravis; ROC Curve; Thymectomy; Thymoma; Thymus Gland; Thymus Neoplasms; Tomography, X-Ray Computed; Young Adult
PubMed: 31331197
DOI: 10.1177/1073274819865281 -
Journal of Thoracic Oncology : Official... Sep 2014Normal thymic architecture is essential for the proper development of T-lymphocytes. Immature T-cell progenitors enter the thymus where through interactions with... (Review)
Review
Normal thymic architecture is essential for the proper development of T-lymphocytes. Immature T-cell progenitors enter the thymus where through interactions with cortical and medullary thymic epithelial cells (TECs) they undergo positive and negative selection and become competent cells that do not react with self-antigens. This process requires normal thymic architecture, expression of major histocompatibility complex (MHC) class II, and normal expression of the autoimmune regulator (AIRE) gene. Thymomas are rare neoplasms of the TECs that often generate lymphocytes that mature into CD4+ and CD8+ T-lymphocytes. However, several abnormalities have been described in thymomas that may affect normal T-cell development: the tumor architecture is distorted, neoplastics expresses less MHC class II, most thymomas do not express AIRE, and production of T-regulator cells is decreased. Thymomas are associated with a variety of autoimmune disorders often linked to T-cell-mediated autoimmunity. Myasthenia gravis, the most common autoimmune disorder associated with thymoma patients, is present in 30% of patients with thymoma. Several theories attempt to explain the association of immune disorders with thymomas. These different theories are based on failure of positive and negative selection of T-lymphocytes and on autoimmunizing mechanisms in an AIRE-poor environment in the thymus. The finding that immunosurveillance against cancer may be impaired before the diagnosis of thymoma may challenge current theories and suggest a more complex defect in T-lymphocyte maturation. It is likely that a combination of mechanisms is responsible for immune disorders in patients with thymoma. More investigation is needed to clarify the basic mechanisms responsible for immune disorders in patients with thymoma.
Topics: Humans; Thymoma; Thymus Neoplasms
PubMed: 25396311
DOI: 10.1097/JTO.0000000000000299 -
Medicine Dec 2022Thymic epithelial tumors (TETs), including thymomas and thymic carcinomas. Thymomas are rare tumors, but are one of the most common mediastinal neoplasms in adults. The...
INTRODUCTION
Thymic epithelial tumors (TETs), including thymomas and thymic carcinomas. Thymomas are rare tumors, but are one of the most common mediastinal neoplasms in adults. The pathology of thymoma with Systemic Lupus Erythematosus (SLE) and severe pancytopenia is rarely reported. Thus, the current study demonstrates a case of thymoma with SLE and immune-related anemia with unique clinical manifestation.
PATIENT CONCERNS
A 27-year-old woman suffered from abdominal pain, arthralgia, intermittent high fever for a long time.
DIAGNOSIS
Based on the clinical and histopathological manifestations, diagnosis of thymoma with SLE and immune-related anemia was established.
INTERVENTIONS
Patient was treated with methylprednisolone and a complete thymectomy and thymomectomy, the CAP regimen was given 4 times of adjuvant chemotherapy after the operation.
OUTCOMES
After inter-disciplinary consultation as well as extensive discussion and steroid pulse therapy underwent surgery, the patient's blood count and immune function gradually entry sent back to normal.
CONCLUSION
we present the diagnosis and treatment of a case of thymoma with SLE and immune-related anemia, and provides references for the clinical diagnosis and treatment of thymoma combined with SLE, and attempts to explain that SLE patients with thymoma may contribute to the clinical remission of SLE after thymoma resection. It should arouse the attention of clinicians when diagnosing and treating related diseases.
Topics: Adult; Female; Humans; Thymoma; Thymus Neoplasms; Lupus Erythematosus, Systemic; Methylprednisolone; Anemia
PubMed: 36626535
DOI: 10.1097/MD.0000000000032077 -
Journal of Thoracic Oncology : Official... Jun 2022To report the trends in incidence and survival associated with thymic epithelial tumors (TETs) in Korea.
INTRODUCTION
To report the trends in incidence and survival associated with thymic epithelial tumors (TETs) in Korea.
METHODS
Data from 1999 to 2017 were obtained from the Korean Central Cancer Registry. Age-standardized incidence rates and average annual percentage changes (AAPCs) were calculated. Net survival (NS) was estimated by the Pohar-Perme method.
RESULTS
Among 5812 patients diagnosed with having TETs, 58.9%, 38.1%, and 3.0% were diagnosed with having thymoma, thymic carcinoma, and thymic neuroendocrine tumor (NET), respectively. Age-standardized incidence rates were 0.50, 0.30, 0.18, and 0.02 per 100,000 for all TETs and the respective subtypes. There was an increase in incidence of all TETs (AAPC = 6.1%) and subtypes: thymoma (AAPC = 5.6%), thymic carcinoma (AAPC = 7.0%), and thymic NET (AAPC = 3.4%). Proportions of patients with thymoma, thymic carcinoma, and thymic NET were 58.9%, 38.1%, and 3.0%, respectively. For thymoma, the relative proportion of distant stage decreased (19.4% in 2005 to 8.8% in 2017) and low-grade WHO subtype (A, AB, B1) increased faster than high-grade WHO type (B2, B3) (AAPC = 19.8% versus 9.6%). For thymoma, the 5-year NS was 82.3%. This increased from 64.3% in 1999 to 2002 to 90.6% in 2013 to 2017. For thymic carcinoma, the 5-year NS was 46.2% and only slightly increased from 39.4% in 1999 to 2002 to 47.9% in 2013 to 2017.
CONCLUSIONS
This study indicates a high incidence of TET and its continuous increase in Korea. The proportion of thymic carcinoma was relatively higher than in the United States or Europe. Survival for thymoma improved during the study period, whereas this was not evident for thymic carcinoma or thymic NET.
Topics: Humans; Incidence; Lung Neoplasms; Neoplasms, Glandular and Epithelial; Neuroendocrine Tumors; Registries; Thymoma; Thymus Neoplasms
PubMed: 35158083
DOI: 10.1016/j.jtho.2022.02.001 -
Journal of Cardiothoracic Surgery Aug 2023Regardless of its rare occurrence, Thymoma remains the most frequently encountered primary tumor of the anterior mediastinum comprising about 50% of all masses in the...
BACKGROUND
Regardless of its rare occurrence, Thymoma remains the most frequently encountered primary tumor of the anterior mediastinum comprising about 50% of all masses in the region. Surgical resection, via thymectomy, remains the mainstay treatment modality. In locally advanced and borderline resectable tumors, neoadjuvant chemotherapy (NACT) may be utilized to increase the chance of R0 resection, raising the question of its efficacy and safety.
METHODS
Demographic and clinical data from patients who presented to a tertiary cancer center between January 2015-October 2021 with a diagnosis of thymoma and underwent curative surgical resection was collected. Computed tomography scan was used to delineate clinical staging, tumor size and to detect post-therapeutic variations in tumor burden. The response evaluation criteria in solid tumors (RECIST) was used to classify the effect of NACT on tumor burden. The pathological response was determined by measuring the percentage of necrotic tissue.
RESULTS
A total of 23 patients were diagnosed with thymoma. Most patients were male with a mean age 46 (± 15) years at diagnosis. The most common clinical stage was stage II with 5 patients (22%). A total of 12 patients had NACT as compared to 11 patients who had upfront surgery. The mean change in tumor volume was 165 cm (p = 0.079) and the change in and maximum diameter was 1.53 ± 1.49 cm (p < 0.01). The effect of NACT on tumor burden based on RECIST criteria was minimal as 8 patients had stable disease. Based on pathological findings, the average necrotic portion of the tumor was 39.5% (p = 0.152). The overall survival rate is 95.65%, mean survival was 115 months (4-125). Recurrence occurred in 5 patients. The NACT group had a higher risk for recurrence (4; 33.3%) with a mean survival of 43.8 months compared to 59.6 months in those who did not receive induction therapy.
CONCLUSIONS
The exact role of induction chemotherapy in locally advanced thymoma patients remains controversial. NACT effect after utilizing radiological and pathological assessment tools was not found to significantly improve oncological outcomes compared to upfront surgery in locally advanced disease, with minimal radiologic and pathologic effect. To further demonstrate the impact of induction chemotherapy, we recommend multicentric collaborative studies.
Topics: Humans; Male; Middle Aged; Female; Thymoma; Neoadjuvant Therapy; Thymus Neoplasms; Mediastinum; Necrosis
PubMed: 37592291
DOI: 10.1186/s13019-023-02357-4 -
Annals of Surgical Oncology Mar 2023Our previous studies have demonstrated that human parvovirus B19 (B19V) is involved in the pathogenesis of thymic hyperplasia-associated myasthenia gravis (MG). However,...
PURPOSE
Our previous studies have demonstrated that human parvovirus B19 (B19V) is involved in the pathogenesis of thymic hyperplasia-associated myasthenia gravis (MG). However, more cases need to be assessed to further elucidate the relationship between this virus and thymoma-associated MG.
MATERIALS AND METHODS
The clinicopathological characteristics, presence of B19V DNA, and B19V VP2 capsid protein expression of 708 cases of thymomas were investigated using nested polymerase chain reaction (PCR), TaqMan quantitative (q) PCR, immunohistochemistry, fluorescent multiplex immunohistochemistry, and electron microscopy.
RESULTS
Patients with MG or ectopic germinal centers (GCs) were significantly younger than those without MG (P < 0.0001) or GCs (P = 0.0001). Moreover, significantly more GCs were detected in thymomas associated with MG than in those without MG (P < 0.0001). The results of nested PCR and TaqMan qPCR were consistent, and B19V DNA positivity was only associated with presence of GCs (P = 0.011). Immunohistochemically, positive staining was primarily detected in neoplastic thymic epithelial cells (TECs) and ectopic GCs. The positive rate of B19V VP2 was significantly higher in thymoma with MG or GCs than in thymoma without MG (P = 0.004) or GCs (P = 0.006). Electron microscopy showed B19V particles in the nuclei of neoplastic TECs and B cells from GCs.
CONCLUSIONS
We conclude that the pathogenesis of MG is closely associated with the presence of GCs, and B19V infection is plausibly an essential contributor to formation of ectopic GCs in thymoma. To the best of the authors' knowledge, this is the first study to elucidate the role of B19V in thymoma-associated MG and provide new ideas for exploring the etiopathogenic mechanism of MG.
Topics: Humans; Parvovirus B19, Human; Thymoma; Myasthenia Gravis; Risk Factors; Thymus Neoplasms
PubMed: 36509875
DOI: 10.1245/s10434-022-12936-9 -
La Clinica Terapeutica 2022This research aimed to evaluate the efficiency of using chemical-shift magnetic resonance imaging (MRI) to differentiate thy-moma from non-thymoma in patients with... (Observational Study)
Observational Study
PURPOSES
This research aimed to evaluate the efficiency of using chemical-shift magnetic resonance imaging (MRI) to differentiate thy-moma from non-thymoma in patients with myasthenia gravis (MG).
METHODS
A total of 137 subjects were split into thymoma and non-thymoma groups. The qualitative parameters and the chemical-shift ratio (CSR) were compared between the two groups, using the Chi-square test and the Student's t-test, respectively. Logistic regression was performed to investigate the significant factors associated with both the qualitative parameters and CSR values that can be used to predict thymoma. The discriminative capability of CSR was defined by the area under the receiver operating characteristic (ROC) curve (AUROC), which was used to compute an optimal cut-off point for thymoma distinction.
RESULTS
Although significant differences between groups were identified by univariate analyses for most of the qualitative parameters, during the multivariate logistic regression, only CSR was significant for the distinction between two groups, with an odds ratio (OR) of 9.700 [95% confidence interval (CI): 1.874-50.200, p = 0.007). The CSR values for the thymoma and non-thymoma groups were 1.020 ± 0.073 and 0.604 ± 0.126, respectively. With an optimal cut-off point defined at 0.825, the AUROC of CSR was 0.982. When applying this cut-off point, the sensitivity and specificity of chemical-shift MRI for the detection of thymoma were 100% and 97.22%, respectively.
CONCLUSIONS
CSR values, calculated from chemical-shift MRI, was exceedingly valuable for distinguishing thymoma from non-thymoma in patients with MG.
Topics: Humans; Thymectomy; Thymoma; Thymus Neoplasms; Myasthenia Gravis; Magnetic Resonance Imaging; Retrospective Studies
PubMed: 36373457
DOI: 10.7417/CT.2022.2484 -
BMC Surgery Aug 2016Malignant thymomas are rarely associated with bone metastasis and T-cell lymphocytosis. (Review)
Review
BACKGROUND
Malignant thymomas are rarely associated with bone metastasis and T-cell lymphocytosis.
CASE PRESENTATION
A 47-year-old female patient was admitted to our hospital for ptosis. A diagnosis of malignant thymoma was made based on the thymectomy and pathological result. Peripheral T-cell lymphocytosis and bone metastasis were found later. T-cell lymphocytosis was relived after surgical and radiation therapy to the metastasis.
CONCLUSION
Peripheral T-cell lymphocytosis is a rare paraneoplastic phenomenon associated with thymomas. This report is the first to describe an invasive thymoma with late bone metastasis accompanied with T-cell lymphocytosis. We should be aware of peripheral T-cell lymphocytosis in thymomas and it may contribute to a better understanding of the complex physiology and pathogenesis of thymoma.
Topics: Bone Neoplasms; Diagnosis, Differential; Female; Humans; Lymphocytosis; Magnetic Resonance Imaging; Middle Aged; T-Lymphocytes; Thymoma; Thymus Neoplasms; Tomography, X-Ray Computed
PubMed: 27542926
DOI: 10.1186/s12893-016-0171-0 -
Cancer Medicine May 2023Due to the low incidence and histological heterogeneity, the molecular features and underlying carcinogenic mechanisms of thymic epithelial tumors (TETs) are yet to be...
BACKGROUND
Due to the low incidence and histological heterogeneity, the molecular features and underlying carcinogenic mechanisms of thymic epithelial tumors (TETs) are yet to be fully elucidated, especially for different subtypes of TETs.
METHODS
Tumor tissue samples of 43 TETs with distinct histological subtypes were collected. We analyzed the molecular characteristics in different subtypes based on whole exome sequencing data.
RESULTS
The mutational profiles of the different subtypes of TETs varied. Compared with thymomas, thymic carcinomas (TCs) had a higher mutation frequency of MYO16 (33% vs. 3%, p = 0.024) and a lower frequency of ZNF729 mutations (0% vs. 35%, p = 0.044). No significant difference was observed in the median tumor mutation burden across different subtypes. The value of copy number variation burden, weighted genome instability index, and the number of amplified segments were all higher in TCs than thymomas, and they also tended to be higher in B3 thymoma than in non-B3 thymomas, while they had no significant differences between B3 thymoma and TCs. Clustering analyses revealed that Wnt, MAPK, Hedgehog, AMPK, and cell junction assembly signaling pathways were exclusively enriched in non-B3 thymomas, lysine degradation pathway in B3 thymoma, and extracellular matrix-receptor (ECM-receptor) interaction, positive regulation of cell cycle process, and activation of innate immune response pathways in TCs.
CONCLUSIONS
This study revealed distinct molecular landscapes of different subtypes of TETs, suggesting diverse pathogenesis of non-B3 thymomas, B3 thymomas, and TCs. Our findings warrant further validation in future large-scale studies and may provide a theoretical basis for potential personalized therapeutic strategies.
Topics: Humans; Thymoma; DNA Copy Number Variations; Thymus Neoplasms; Neoplasms, Glandular and Epithelial; Molecular Biology
PubMed: 36916520
DOI: 10.1002/cam4.5795