Department of Surgery, University of California, San Francisco, CA, USA.
Future Oncol. 2009 Oct;5(8):1283-93. doi: 10.2217/fon.09.85.
There has been considerable progress identifying biomarkers in thyroid tumors that improve the accuracy of fine-needle aspiration biopsy and also help predict tumor aggressiveness or behavior. In this review we address both the clinical potential of molecular biomarkers and their usefulness, based on the most recent literature. We describe the current best clinical staging systems and the common somatic mutations in thyroid cancer. The BRAF mutation is the most common mutation in papillary thyroid cancer and has recently been reported to be associated with disease aggressiveness; it is also an independent predictor of tumor behavior. Combined testing of RET/PTC, NTRK, RAS and PAX8-PPARgamma, which are mutually exclusive mutations, helps improve the accuracy of fine-needle aspiration biopsy. Gene-expression profiling studies have identified a variety of potential molecular markers to help distinguish benign from malignant thyroid neoplasms. Expression analysis of differentially expressed microRNAs also appears to be a promising diagnostic approach for distinguishing benign from malignant thyroid neoplasm. It is especially useful for indeterminate nodules by fine-needle aspiration biopsy.
在识别甲状腺肿瘤的生物标志物方面已经取得了相当大的进展，这些标志物可以提高细针穿刺活检的准确性，还有助于预测肿瘤的侵袭性或行为。在这篇综述中，我们根据最新的文献，讨论了分子生物标志物的临床潜力及其用途。我们描述了目前最好的临床分期系统和甲状腺癌的常见体细胞突变。BRAF 突变是甲状腺乳头状癌中最常见的突变，最近有报道称其与疾病侵袭性相关；它也是肿瘤行为的独立预测因子。RET/PTC、NTRK、RAS 和 PAX8-PPARγ 的联合检测，这些是相互排斥的突变，有助于提高细针穿刺活检的准确性。基因表达谱研究已经确定了多种潜在的分子标记物，以帮助区分良性和恶性甲状腺肿瘤。差异表达 microRNAs 的表达分析似乎也是区分良性和恶性甲状腺肿瘤的一种很有前途的诊断方法。对于细针穿刺活检不确定的结节尤其有用。
