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文中综述了有关胸腺上皮性肿瘤分子病理的研究现状,分子遗传学研究发现,WHO胸腺瘤分类的A型和AB型,出现遗传学变异率较低(7%～8%),B2及B3型胸腺瘤变异率较高(近20%)。近年来的研究热点集中在该类肿瘤的信号通路及靶向治疗。从免疫组化研究提示,表皮生长因子受体(epidermal growth factor receptor,EGFR)在胸腺瘤及胸腺癌表达水平通常较高,而荧光原位杂交(fluorescence in situ hybridization,FISH)检测则发现,EGFR几乎很少出现基因突变(1.9%),少数报道肯定了胸腺肿瘤EGFR靶向治疗的应用前景。对v-kit猫科肉瘤病毒转化基因(v-kit Hardy-Zuckerman 4 feline sarcomaviral oncogene hemolog,KIT)的研究表明,有2%胸腺瘤及79%胸腺癌中KIT呈高表达,而仅7%的胸腺癌存在KIT的突变,且KIT高表达与KIT突变无相关性。有人认为,在胸腺肿瘤中KIT突变的临床意义具有局限性。此外,对于胰岛素样生长因子1受体(insulin-like growth factor-1 receptor,IGF-1R)、血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)信号通路运用于胸腺上皮性肿瘤靶向治疗的效果,其相关临床研究尚在进行中。
In this paper, the current status of research on the molecular pathology of thymic epithelial tumors was reviewed. According to the molecular genetic studies, the WHO classification of type A and AB of thymoma showed low genetic variation (7% -8%), B2 and B3 Thymoma mutation rate higher (nearly 20%). In recent years, research focuses on the signaling pathways and targeted therapies of these tumors. Immunohistochemical studies suggest that the expression of epidermal growth factor receptor (EGFR) is usually high in thymoma and thymic carcinomas, while fluorescence in situ hybridization (FISH) results show that EGFR Few mutations (1.9%) are rare, and few reports confirm the potential of EGFR targeted therapy in thymus tumors. A study of v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene hemolog (KIT) showed that KIT was highly expressed in 2% of thymoma and 79% of thymoma, whereas only 7% of There is KIT mutation in thymic carcinoma, and there is no correlation between KIT high expression and KIT mutation. Some people think that the clinical significance of KIT mutations in thymic tumors has limitations. In addition, the use of insulin-like growth factor-1 receptor (IGF-1R) and vascular endothelial growth factor receptor (VEGFR) signaling in thymic epithelial tumor targeting The effect of treatment, its related clinical research is still underway.