Tennakoon T M P B, Rushdhi M, Ranasinghe A D C U, Dassanayake R S
The Biochemistry and Molecular Biology Unit, Department of Chemistry, Faculty of Science, University of Colombo, Colombo 03, Sri Lanka.
J Cancer Res Clin Oncol. 2017 Jun;143(6):913-931. doi: 10.1007/s00432-016-2319-9. Epub 2016 Dec 22.
Thyroid cancer (TC), follicular adenoma (FA) and Hashimoto's thyroiditis (HT) are three of the most frequently reported abnormalities that affect the thyroid gland. A frequent co-occurrence along with similar histopathological features is observed between TC and FA as well as between TC and HT. The conventional diagnostic methods such as histochemical analysis present complications in differential diagnosis when these abnormalities occur simultaneously. Hence, the authors recognize novel methods based on screening genetic defects of thyroid abnormalities as viable diagnostic and prognostic methods that could complement the conventional methods.
We have extensively reviewed the existing literature on TC, FA and HT and also on three genes, namely braf, nras and ret/ptc, that could be used to differentially diagnose the three abnormalities. Emphasis was also given to the screening methods available to detect the said molecular markers.
It can be conferred from the analysis of the available data that the utilization of braf, nras and ret/ptc as markers for the therapeutic evaluation of FA and HT is debatable. However, molecular screening for braf, nras and ret/ptc mutations proves to be a conclusive method that could be employed to differentially diagnose TC from HT and FA in the instance of a suspected co-occurrence. Thyroid cancer patients can be highly benefited from the screening for the said genetic markers, especially the braf gene due to its diagnostic value as well as due to the availability of personalized medicine targeted specifically for braf mutants.
甲状腺癌（TC）、滤泡性腺瘤（FA）和桥本甲状腺炎（HT）是影响甲状腺的三种最常报告的异常情况。在TC与FA之间以及TC与HT之间经常观察到同时出现且具有相似的组织病理学特征。当这些异常同时出现时，诸如组织化学分析等传统诊断方法在鉴别诊断中存在困难。因此，作者认为基于筛查甲状腺异常的基因缺陷的新方法是可行的诊断和预后方法，可以补充传统方法。
我们广泛回顾了关于TC、FA和HT以及三个基因（即braf、nras和ret/ptc）的现有文献，这三个基因可用于鉴别诊断这三种异常情况。还重点介绍了可用于检测上述分子标志物的筛查方法。
从现有数据分析可以推断，将braf、nras和ret/ptc用作FA和HT治疗评估标志物的实用性存在争议。然而，对braf、nras和ret/ptc突变进行分子筛查被证明是一种决定性方法，可用于在怀疑同时出现的情况下将TC与HT和FA进行鉴别诊断。甲状腺癌患者可以从对上述基因标志物的筛查中受益匪浅，特别是braf基因，因为它具有诊断价值以及有专门针对braf突变体的个性化药物。
