Melaccio Assunta, Sgaramella Lucia Ilaria, Pasculli Alessandro, Di Meo Giovanna, Gurrado Angela, Prete Francesco Paolo, Vacca Angelo, Ria Roberto, Testini Mario
Operative Unit of Internal Medicine "G. Baccelli", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, 70124 Bari, Italy.
Academic General Surgery Unit "V. Bonomo", Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro" Medical School, 70124 Bari, Italy.
Cancers (Basel). 2021 Jun 3;13(11):2775. doi: 10.3390/cancers13112775.
Thyroid cancer is the most common endocrine malignancy, with a typically favorable prognosis following standard treatments, such as surgical resection and radioiodine therapy. A subset of thyroid cancers progress to refractory/metastatic disease. Understanding how the tumor microenvironment is transformed into an angiogenic microenvironment has a role of primary importance in the aggressive behavior of these neoplasms. During tumor growth and progression, angiogenesis represents a deregulated biological process, and the angiogenic switch, characterized by the formation of new vessels, induces tumor cell proliferation, local invasion, and hematogenous metastases. This evidence has propelled the scientific community's effort to study a number of molecular pathways (proliferation, cell cycle control, and angiogenic processes), identifying mediators that may represent viable targets for new anticancer treatments. Herein, we sought to review angiogenesis in thyroid cancer and the potential role of proangiogenic cytokines for risk stratification of patients. We also present the current status of treatment of advanced differentiated, medullary, and poorly differentiated thyroid cancers with multiple tyrosine kinase inhibitors, based on the rationale of angiogenesis as a potential therapeutic target.
甲状腺癌是最常见的内分泌恶性肿瘤，在接受手术切除和放射性碘治疗等标准治疗后，其预后通常良好。一部分甲状腺癌会进展为难治性/转移性疾病。了解肿瘤微环境如何转变为血管生成微环境对于这些肿瘤的侵袭性至关重要。在肿瘤生长和进展过程中，血管生成是一个失调的生物学过程，以新血管形成为特征的血管生成开关会诱导肿瘤细胞增殖、局部侵袭和血行转移。这一证据促使科学界努力研究多种分子途径（增殖、细胞周期控制和血管生成过程），以确定可能成为新抗癌治疗可行靶点的介质。在此，我们试图综述甲状腺癌中的血管生成以及促血管生成细胞因子在患者风险分层中的潜在作用。我们还基于血管生成作为潜在治疗靶点的原理，介绍了使用多种酪氨酸激酶抑制剂治疗晚期分化型、髓样和低分化甲状腺癌的现状。
