Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, Pennsylvania State University - Milton S. Hershey Medical Center, 500 University Drive Mail Code H091, Hershey, PA 17033-0850, USA.
Adv Exp Med Biol. 2013;779:309-26. doi: 10.1007/978-1-4614-6176-0_14.
Thyroid cancer has an increasing incidence in the US population and worldwide, with 95% of the cancers being of follicular cell origin-papillary, follicular, or anaplastic thyroid carcinomas. Both follicular and papillary thyroid cancers portend good survival rates, with estimated 5-year survival amongst differentiated thyroid cancer approaching 97%. On the other hand, the median survival for a patient with anaplastic thyroid carcinoma is measured in months. Despite the optimistic survival rates for papillary and follicular thyroid carcinoma, a subset of this population demonstrates resistance to radioactive iodine, and a proclivity for more aggressive tumors with higher rates of recurrence and metastasis.As there is an increased understanding of the molecular etiology of thyroid cancer, there is also a new interest in alternative treatment methods for those nonresponsive to typical treatment. Multiple signaling pathways have been identified, including the mitogen activated protein kinase pathway, as crucial to thyroid tumor formation and progression. Additionally, particular oncogenes have been identified as prevalent in anaplastic thyroid carcinoma and thought to be involved in the transformation from differentiated to anaplastic histology.We review the current literature and evidence describing the molecular and genetic etiology of non-medullary (follicular cell derived) thyroid carcinomas including papillary, follicular, and anaplastic thyroid carcinoma. Additionally, we evaluate the current literature on emerging and established therapies of molecular and genetic targets in these cancers.
甲状腺癌在美国和全球的发病率呈上升趋势，其中 95%的癌症来源于滤泡细胞——甲状腺乳头状癌、滤泡状癌或间变性癌。滤泡状癌和甲状腺乳头状癌的预后均较好，分化型甲状腺癌的 5 年生存率估计接近 97%。另一方面，间变性甲状腺癌患者的中位生存期以月计。尽管甲状腺乳头状癌和滤泡状癌的生存率乐观，但该人群中有一部分对放射性碘治疗有耐药性，并且倾向于发生更具侵袭性的肿瘤，复发和转移的发生率更高。随着对甲状腺癌分子病因学认识的提高，人们对那些对典型治疗方法无反应的患者的替代治疗方法也产生了新的兴趣。已经确定了多种信号通路，包括丝裂原激活蛋白激酶通路，这些通路对甲状腺肿瘤的形成和进展至关重要。此外，特定的癌基因已被确定为间变性甲状腺癌中常见的，并被认为参与了从分化型到间变性组织学的转化。我们回顾了描述非髓样（滤泡细胞来源）甲状腺癌包括甲状腺乳头状癌、滤泡状癌和间变性癌的分子和遗传病因的现有文献和证据。此外，我们评估了这些癌症中分子和遗传靶点的新兴和既定治疗方法的现有文献。
