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甲状腺乳头状癌变体

Papillary thyroid carcinoma variants.

作者信息

Lloyd Ricardo V, Buehler Darya, Khanafshar Elham

机构信息

Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.

出版信息

Head Neck Pathol. 2011 Mar;5(1):51-6. doi: 10.1007/s12105-010-0236-9. Epub 2011 Jan 8.

Abstract

Papillary thyroid carcinomas are the most common thyroid cancers and constitute more than 70% of thyroid malignancies. The most common etiologic factor is radiation, but genetic susceptibility and other factors also contribute to the development of papillary thyroid carcinoma. The most common variants include conventional, follicular variant and tall cell variant. However, many other uncommon variants have been described including oncocytic, columnar cell, diffuse sclerosing and solid forms. Immunohistochemical staining with TTF-1 and thyroglobulin is very useful in confirming the diagnosis of papillary thyroid carcinoma especially in metastatic sites. Markers such as HBME-1 and CITED1 can assist in separating some difficult cases of follicular variants of papillary thyroid carcinomas from follicular adenomas. Molecular studies have shown that the BRAF V600E mutation is found mainly in papillary and anaplastic thyroid carcinomas. Other molecular markers such as HMGA2 and insulin-like growth factor II mRNA binding protein 3 have been used recently as molecular tests to separate papillary thyroid carcinoma and its variants from follicular adenomas and other benign thyroid nodules.

摘要

乳头状甲状腺癌是最常见的甲状腺癌,占甲状腺恶性肿瘤的70%以上。最常见的病因是辐射,但遗传易感性和其他因素也与乳头状甲状腺癌的发生有关。最常见的变体包括传统型、滤泡状变体和高细胞变体。然而,已经描述了许多其他不常见的变体,包括嗜酸性细胞型、柱状细胞型、弥漫性硬化型和实体型。用甲状腺转录因子-1(TTF-1)和甲状腺球蛋白进行免疫组化染色在确诊乳头状甲状腺癌方面非常有用,尤其是在转移部位。诸如人鼠杂交瘤单克隆抗体-1(HBME-1)和含p300/CBP结合蛋白的转录激活因子1(CITED1)等标志物有助于将一些乳头状甲状腺癌滤泡状变体的疑难病例与滤泡性腺瘤区分开来。分子研究表明,BRAF V600E突变主要见于乳头状和间变性甲状腺癌。其他分子标志物,如高迁移率族蛋白A2(HMGA2)和胰岛素样生长因子II信使核糖核酸结合蛋白3(IGF2BP3),最近已被用作分子检测手段,以将乳头状甲状腺癌及其变体与滤泡性腺瘤和其他良性甲状腺结节区分开来。

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