Volante Marco, Rapa Ida, Papotti Mauro
Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Turin, Italy.
Endocr Pathol. 2008 Fall;19(3):150-5. doi: 10.1007/s12022-008-9040-4.
Poorly differentiated thyroid carcinomas are a heterogeneous group of tumors occupying an area intermediate between well-differentiated follicular or papillary carcinoma and anaplastic carcinomas, from both a histopathogenetic and a clinical point of view. Large tumor series selected on the basis of structural and/or other morphological criteria showed that poorly differentiated carcinomas have a distinct biological behavior, and the classification of these tumors into a separate group appears justified, although strict homogeneous diagnostic criteria should be achieved and widely accepted to better characterize such tumor entity. Moreover, the identification of the prognostic parameters segregating aggressive from indolent cases has important clinical implications. Molecular data in the literature, although limited by the heterogeneous case series analyzed, identify ras alterations as the most common molecular alteration in poorly differentiated carcinomas, thus, depicting a peculiar molecular pathway in this tumor type as compared to well-differentiated follicular and papillary carcinomas. The present paper aims to review the various aspects of this tumor type, from morphology to immunohistochemistry and molecular abnormalities from a practical and daily practice-oriented point of view.
从组织病理发生学和临床角度来看，低分化甲状腺癌是一组异质性肿瘤，其处于高分化滤泡状或乳头状癌与未分化癌之间。基于结构和/或其他形态学标准选择的大型肿瘤系列研究表明，低分化癌具有独特的生物学行为，将这些肿瘤归为一个单独的组似乎是合理的，尽管应该达成并广泛接受严格的同质化诊断标准，以便更好地描述这种肿瘤实体。此外，识别区分侵袭性病例与惰性病例的预后参数具有重要的临床意义。文献中的分子数据虽然受到所分析的异质性病例系列的限制，但将ras改变确定为低分化癌中最常见的分子改变，因此，与高分化滤泡状和乳头状癌相比，描绘了这种肿瘤类型中一种独特的分子途径。本文旨在从实际和日常实践的角度综述这种肿瘤类型的各个方面，从形态学到免疫组织化学以及分子异常。
