Hunt Jennifer
University of Pittsburgh Medical Center Department of Pathology, USA.
Endocr Pathol. 2005 Winter;16(4):311-21. doi: 10.1385/ep:16:4:311.
Tumors of the thyroid with a follicular growth pattern are controversial and can be diagnostically challenging for the pathologist. This group of tumors includes both follicular derived lesions (adenomas and carcinomas) and papillary carcinoma (follicular variant of papillary carcinoma). H&E morphology has classically been the gold standard for diagnosis. In the past several decades, however, several important molecular markers have been identified that may be unique to different types of thyroid carcinomas. These include the translocations RET/PTC and PAX8-PPARgamma and point mutations in the BRAF and RAS genes. Other molecular events in tumor suppressor genes may be useful for diagnosis of these tumors as well. None of the mutational markers are very sensitive, and there is some question regarding specificity for malignancy, because mutations have also been described in histologically benign tumors. However, with increasing availability of molecular testing for the general pathologist, a molecular testing panel used in conjunction with the H&E morphology and immunohistochemical stains may become useful in the clinical setting for the diagnosis of thyroid tumors.
具有滤泡状生长模式的甲状腺肿瘤存在争议，对病理学家来说在诊断上具有挑战性。这组肿瘤包括滤泡来源的病变（腺瘤和癌）以及乳头状癌（乳头状癌的滤泡变体）。传统上，苏木精-伊红染色（H&E）形态学一直是诊断的金标准。然而，在过去几十年中，已经鉴定出几种重要的分子标志物，它们可能是不同类型甲状腺癌所特有的。这些包括RET/PTC和PAX8-PPARγ易位以及BRAF和RAS基因中的点突变。肿瘤抑制基因中的其他分子事件可能对这些肿瘤的诊断也有用。没有一种突变标志物非常敏感，并且关于其对恶性肿瘤的特异性存在一些疑问，因为在组织学上良性的肿瘤中也描述过突变。然而，随着普通病理学家越来越容易获得分子检测，结合H&E形态学和免疫组化染色使用的分子检测 panel 在甲状腺肿瘤的临床诊断中可能会变得有用。
