Tong Junyu, Ruan Maomei, Jin Yuchen, Fu Hao, Cheng Lin, Luo Qiong, Liu Zhiyan, Lv Zhongwei, Chen Libo
Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China.
Eur Thyroid J. 2022 Mar 24;11(2):e220021. doi: 10.1530/ETJ-22-0021.
Poorly differentiated thyroid carcinoma (PDTC) is a rare thyroid carcinoma originating from follicular epithelial cells. No explicit consensus can be achieved to date due to sparse clinical data, potentially compromising the outcomes of patients. In this comprehensive review from a clinician's perspective, the epidemiology and prognosis are described, diagnosis based on manifestations, pathology, and medical imaging are discussed, and both traditional and emerging therapeutics are addressed as well. Turin consensus remains the mainstay diagnostic criteria for PDTC, and individualized assessments are decisive for treatment option. The prognosis is optimal if complete resection is performed at early stage but dismal in nearly half of patients with locally advanced and/or distant metastatic diseases, in which adjuvant therapies such as 131I therapy, external beam radiation therapy, and chemotherapy should be incorporated. Emerging therapeutics including molecular targeted therapy, differentiation therapy, and immunotherapy deserve further investigations to improve the prognosis of PDTC patients with advanced disease.
低分化甲状腺癌(PDTC)是一种起源于滤泡上皮细胞的罕见甲状腺癌。由于临床数据稀少,迄今为止尚未达成明确共识,这可能会影响患者的治疗结果。从临床医生的角度进行的这项全面综述中,描述了其流行病学和预后,讨论了基于临床表现、病理学和医学影像学的诊断方法,还探讨了传统和新兴的治疗方法。都灵共识仍然是PDTC的主要诊断标准,个体化评估对治疗方案的选择至关重要。如果在早期进行完全切除,预后最佳,但在近一半局部晚期和/或远处转移性疾病患者中预后不佳,这些患者应采用辅助治疗,如¹³¹I治疗、外照射放疗和化疗。包括分子靶向治疗、分化治疗和免疫治疗在内的新兴治疗方法值得进一步研究,以改善晚期PDTC患者的预后。