甲状腺癌分子生物学的研究进展

Recent developments of molecular biology in thyroid cancer

目的:研究甲状腺癌分子生物学的进展为临床应用提供可靠的理论依据。方法:应用Medline、PubMed及CNKI期刊全文数据库检索系统,以"甲状腺癌、癌基因和分子标志"等为关键词,检索1990-2011年的相关文献。纳入标准:1)甲状腺癌发生发展过程中相关的分子生物学改变;2)分子生物学改变的检测技术和临床应用。符合要求纳入分析的文献32篇。结果:近年来的研究发现,在甲状腺癌的发生发展过程中涉及大量相关基因结构和表达调控的改变。其中研究较多且特异性强的分子标志包括BRAF、Ret/PTC、Ras和PAX8/PPARγ等。现今,甲状腺细针抽吸(fine-needle aspiration,FNA)活检技术已成为诊断结节性甲状腺疾病,鉴别肿瘤良恶性最为可行的方法之一。更为重要的是,对FNA样本进行基因突变检测已被证明可明显提高结节性甲状腺疾病细胞学诊断的准确度。结论:对FNA活检样本检测多位点甲状腺癌分子标志,将有助于结节性甲状腺疾病的病理诊断、治疗及预后评价。

OBJECTIVE：To make a review about recent developments provide a dependable theoretical basis for the clinical application.METHODS：By searching for the terms,such as thyroid cancer,oncogene,molecular marker in the Medline,PubMed and CNKI databases（1990-2011）,and 32 studies were collected and analyzed.The inclusion criteria were as follows：1） molecular mutations in thyroid cancer 2） the diagnostic technique for the molecular mutations and clinic application.RESULTS：Recently,a great quantity of molecular mutations and gene expression alterations in thyroid cancer have been discovered and characterized.The major and high specific molecular markers in thyroid cancer among them are as follows：BRAF,Ret/PTC,Ras,PAX8/PPARγ,and so on.Up to the date,fine-needle aspiration（FNA） has been considered as the one of the most available tools for pathologic diagnosis and differentiating benign and malignant thyroid nodules.Furthermore,it has been demonstrated that molecular mutation testing of thyroid FNA samples significantly enhances the diagnostic accuracy of FNA cytology.CONCLUSION：Testing for thyroid cancer-specific molecular marker mutation in thyroid FNA samples will be contributive to the pathologic diagnosis,clinical treatment and tumor prognostication of thyroid nodules.