Objective: To investigate the incidence of thymic tumors in Guangzhou, its association with EBV infection and the cell proliferation and apoptosis characteristics of these tumors.

Methods: EBV encoded small RNAs (EBERs) were detected in 43 thymic tumors and 7 thymic hyperplasia samples by use of in situ hybridization, EBNA-1, LMP-1, PCNA, bcl-2 and p53 were examined using immunohistochemical methods, cell apoptosis was evaluated by TUNEL (TdT-mediated dUTP-X nick end labelling) in situ cell death detection kit.

Results: 1. Thymic diseases only accounted for 0.057% of biopsies in the Guangzhou area. Thymic tumor and hyperplasia accounted for 74.7% and 18.6% in thymic diseases respectively. Thymic lymphoepithelimoa-like carcinoma (LELC) occurred in 2.7% of thymic tumors. 2. EBV encoded products (EBERs, EBNA-1 and LMP-1) were not detected in 50 thymic disease specimens. 3. Marked proliferation (3+-4+) grade thymomas (0/18 cases) was much lower than that of thymic carcinomas (10/20 cases), and the marked apoptotic (2+-4+) grade was higher in thymomas (15/18) than the thymic carcinomas (13/20). 4. The p53 protein accumulation rate in thymic carcinomas (8/20) was significantly higher than that of thymomas (1/18). The apoptotic grade is significantly related to p53 accumulation in thymic epithelial tumors. 5. The bcl-2 over expression could be detected both in thymomas and thymic carcinomas.

Conclusions: 1. Thymic diseases, including thymic LELC, is very rare in Guangzhou and is not closely associated with EBV infection. 2. Thymic carcinomas have a relatively rapid growth rate compared to thymomas. 3. p53 gene mutation may play an important role in the carcinogenesis of thymic carcinoma, and bcl-2 over-expression may also be involved in the evolution of thymic epithelial tumors. 4. Wild type p53 protein may exert an apoptosis-inducing function in thymic epithelial tumors, including thymomas and carcinomas, and a proliferation inhibiting function only in thymomas.