BACKGROUNDAlthough 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.METHODSClinical 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.RESULTSThere 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.CONCLUSIONSThis 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. Cancer 2002;94:624–32. © 2002 American Cancer Society.DOI 10.1002/cncr.10225

Long-term VPA monotherapy can increase bone resorption, leading to decreased BMD.

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Expression of theThe Wilms' tumor gene WT1 was originally isolated as a tumorsuppressor gene responsible for Wilms' tumor, a kidney neoplasm of childhood. 1 However, we proposed that WT1 played an oncogenic role in leukemogenesis based on the following findings: 2 (i) the wild-type WT1 gene was expressed at high levels in leukemic blast cells, 3,4 (ii) there was a clear and inverse correlation between WT1 expression levels and prognosis in acute leukemia, 3 (iii) WT1 expression increased at relapse of acute leukemia, 5 (iv) growth of leukemic blast cells was inhibited by the treatment of WT1 antisense oligomers 6 and (v) constitutive expression of WT1 blocked differentiation and instead induced proliferation in response to granulocyte colony-stimulating factor in 32D cl3 myeloid progenitor cells 7 and normal myeloid progenitor cells. 8 Furthermore, we demonstrated that the wild-type WT1 as expressed in various types of cell line derived from lung cancer, gastric cancer, colon cancer and breast cancer and that growth of these WT1-expressing tumor cells was inhibited by the treatment of WT1 antisense oligomers. 9 These data suggested an oncogenic role of the WT1 gene in tumorigenesis. However, the involvement of the WT1 gene in de novo solid tumors remained unclear. In the present study, we examined WT1 expression in de novo lung cancer using quantitative real-time RT-PCR and immunohistochemistry and demonstrated that the wild-type WT1 was overexpressed in 54/56 (96%) de novo non-small cell lung cancers (NSCLCs) and 5/6 (83%) de novo small cell lung cancers (SCLCs) examined.