胸腺被认为是成人的非功能性残余,但一些证据表明,它可能有残余活动。肺癌患者代表了研究胸腺残留活性的理想模型,因为他们的胸腺在手术过程中很容易收获。设计该研究以证实在成年小鼠(步骤1)和人(步骤2)中均存在残余胸腺活性。在步骤1中,通过在20只年轻和成年小鼠的队列中激活k-ras突变来诱导肺癌。杀人后,分析胸腺和肺。当髓质明显时,胸腺被认为是活跃的,皮质-髓质比率为50:50或更高,并且存在脂肪退化。在步骤2中,一组20名患者,正在接受肺癌手术,做了心包脂肪垫活检,异位胸腺的部位。如果检测到Hassall的尸体,则认为存在胸腺。在老鼠身上,活跃的胸腺在高比例的病例中被检测到,成人和年轻人之间没有显着差异(分别为70%和44.4%)。2例没有肺部肿瘤的证据,胸腺功能齐全。在人类中,2例(10.5%)在心包脂肪垫中发现异位胸腺,通过免疫组织化学证实。在另外8名患者中检测到先前胸腺活动的迹象。结果证实了动物模型和肺癌患者的胸腺活性,为未来的系统性纵隔胸腺活检提供了理论基础。理解胸腺之间的相互作用,淋巴细胞和肿瘤可能在肺癌中开辟一个新的潜在靶向观点。
Thymus is considered a non-functional remnant in adults, but some evidence suggest that it may harbor residual activity. Lung cancer patients represent the ideal model to study thymic residual activity, as their
thymus can be easily harvested during surgery. This study was designed to confirm the presence of residual thymic activity both in adult mice (step 1) and in humans (step 2). In step 1, lung cancer was induced by activating k-ras mutation in a cohort of 20 young and adult mice. After killing,
thymus and lungs were analyzed. Thymus was considered active when medullary was evident, cortico-medullary ratio was 50:50 or higher and adipose involution was present. In step 2, a cohort of 20 patients, undergoing surgery for lung cancer, had biopsy of pericardial fat pad, site of ectopic thymus.
Thymus was considered present if Hassall\'s bodies were detected. In mice, active thymus was detected in a high proportion of cases, without significant difference between adult and young (70% vs 44.4% respectively). Two cases without evidence of lung tumor had a fully functional
thymus. In humans, ectopic thymus was detected in the pericardial fat pad in 2 cases (10.5%), confirmed by immunohistochemistry. Signs of previous thymic activity were detected in 8 additional patients. Results confirmed thymus activity in animal models and humans with lung cancer, providing the rationale for future systematic mediastinal thymic biopsy. The comprehension of interactions between thymus, lymphocytes and tumor may open a new potentially targetable perspective in lung cancer.