低分化甲状腺癌的研究进展

Research progress in poorly differentiated thyroid carcinoma

低分化甲状腺癌(poorly differentiated thyroid cancer,PDTC)是一种特殊类型的甲状腺癌,其形态学和生物学行为介于分化型甲状腺癌与未分化癌之间。目前PDTC的诊断主要依靠病理检查,诊断标准尚不统一,国际上较多采用"都灵标准"。PDTC的治疗方案采取以手术为主的综合治疗,但辅助治疗仍存在争议。高龄、最初TNM分期及手术完整性是影响PDTC预后的主要因素,区别具有嗜酸性表型的PDTC可能有着重要意义。一些常见的免疫组织化学所识别的分子标志物(如胰岛素样生长因子ⅡmRNA结合蛋白3、E-钙黏蛋白和细胞增殖抗原ki67等)可用来与其他细胞来源的恶性甲状腺肿瘤鉴别。PDTC相关分子标志物及其对PDTC大样本病例的特征研究,有助于进一步完善PDTC的诊断和揭示PDTC的发病机制。

Poorly differentiated thyroid carcinoma(PDTC) is a special type of thyroid carcinoma,the morphology and biological behavior of which are between well-differentiated and undifferentiated(anaplastic) carcinomas.Currently,the diagnosis of PDTC mainly relies on the pathological standards.Although 'Turin standards' is commonly used,there is no generally accepted diagnostic criteria.Surgery is still the main treatment for PDTC,but the adjuvant therapies are in dispute.Age,tumor node metastasis(TNM) stage and integrity of surgical of PDTC are major factors that affect the prognosis.The identification of eosinophilic phenotype(hurthle cells) of PDTC is important.Some common immunohistochemical and molecular biomarkers,such as the insulinPoorly dif erentiated thyroid carcinoma(PDTC) is a special type of thyroid carcinoma, the morphology and biological behavior of which are between well-differentiated and undifferentiated(anaplastic) carcinomas. Currently, the diagnosis of PDTC mainly relies on the pathological standards. Although 'Turin standards' is commonly used, there is no generally accepted diagnostic criteria. Surgery is still the main treatment for PDTC, but the adjuvant therapies are in dispute. Age, tumor node metastasis(TNM) stage and integrity of surgical of PDTC are major factors that affect the prognosis. The identification of eosinophilic phenotype(hurthle cells) of PDTC is important. Some common immunohistochemical and molecular biomarkers, such as the insulin-like growth factor II mR NA-binding protein 3(IMP3), E-cadherin and proliferating protein Ki67, may be helpful for distinguishing PDTC from other thyroid carcinoma. With the progress in studies regarding molecular markers for PDTC and the clinical characters of PDTC patients with large samples, the diagnosis for PDTC will greatly improved and the pathogenesis for PDTC will be elucidated.