甲状腺癌分子诊断和靶向治疗的新进展及应用

New progress and application of molecular diagnosis and targeted therapy of thyroid cancer

甲状腺癌的发生及进展与一系列的分子改变及信号通路的激活有关,这也是药物靶向治疗的基础。对于不可手术的局部晚期、转移性、难治性、特别是未分化甲状腺癌,以酪氨酸激酶抑制剂(tyrosine kinase inhibitors,TKIs)为代表的靶向药物疗效已被临床试验所证实,可缓解临床症状,改善患者生活质量,延长疾病无进展生存期,甚至创造根治手术或再次手术的机会。本文总结了甲状腺癌发生发展过程中关键的分子事件,并归纳了不同TKIs在难治性晚期甲状腺癌临床研究中的有效性和安全性结果,旨在为患者个体化的靶向治疗提供借鉴和参考。

The occurrence and progression of thyroid cancer are related to a series of molecular changes and the activation of signaling pathways,which is the basis of targeted therapy.For inoperable locally advanced,metastatic and refractory thyroid cancer,especially anaplastic thyroid cancer,the efficacy of targeted therapies,particularly tyrosine kinase inhibitors(TKIs),has been demonstrated in clinical trials.TKIs can relieve clinical symptoms,improve patients’quality of life,prolong the progress free survival,and even create opportunities for radical operation or reoperation.This article reviews and summarizes the key molecular events in tumorigenesis and progression of thyroid cancer,and analyzes the results of clinical studies on the efficacy and safety of different TKIs in refractory advanced thyroid cancer,in order to provide reference and assistance for individualized targeted therapy of patients.