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甲状腺乳头状癌:流行病学、基因组学和分类学的现状。

Papillary Thyroid Carcinoma: Current Position in Epidemiology, Genomics, and Classification.

机构信息

Cancer Molecular Pathology of School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.

Pathology Queensland, Gold Coast University Hospital, Southport, QLD, Australia.

出版信息

Methods Mol Biol. 2022;2534:1-15. doi: 10.1007/978-1-0716-2505-7_1.

Abstract

Papillary thyroid carcinoma is the most common type of thyroid malignancy both in adults and pediatric population. Since the 1980s, there are changes in criteria in labelling thyroid lesions as "papillary thyroid carcinomas." Radiation exposure is a well-established risk factor for papillary thyroid carcinoma. Other environmental risk factors include dietary iodine, obesity, hormones, and environmental pollutants. Papillary thyroid carcinomas could occur in familial settings, and 5% of these familial cases have well-studied driver germline mutations. In sporadic papillary thyroid carcinoma, BRAF mutation is common and is associated with clinicopathologic and prognostic markers. The mutation could aid in the clinical diagnosis of papillary thyroid carcinoma. Globally, thyroid cancer is among the top ten commonest cancer in females. In both adult and pediatric populations, there are variations of prevalence of thyroid cancer and rising incidence rates of thyroid cancer worldwide. The increase of thyroid cancer incidence was almost entirely due to the increase of papillary thyroid carcinoma. The reasons behind the increase are complex, multifactorial, and incompletely understood. The most obvious reasons are increased use of diagnostic entities, change in classification of thyroid neoplasms, as well as factors such as obesity, environmental risk factors, and radiation. The prognosis of the patients with papillary thyroid carcinoma is generally good after treatment. Nevertheless, cancer recurrence and comorbidity of second primary cancer may occur, and it is important to have awareness of the clinical, pathological, and molecular parameters of papillary thyroid carcinoma.

摘要

甲状腺乳头状癌是成人和儿童人群中最常见的甲状腺恶性肿瘤类型。自 20 世纪 80 年代以来,甲状腺病变标记为“甲状腺乳头状癌”的标准有所改变。辐射暴露是甲状腺乳头状癌的一个明确的危险因素。其他环境危险因素包括饮食碘、肥胖、激素和环境污染物。甲状腺乳头状癌可能发生在家族环境中,这些家族病例中有 5%的病例有研究充分的驱动基因突变。在散发性甲状腺乳头状癌中,BRAF 突变很常见,与临床病理和预后标志物相关。该突变有助于甲状腺乳头状癌的临床诊断。在全球范围内,甲状腺癌是女性中最常见的癌症之一。在成人和儿童人群中,甲状腺癌的患病率存在差异,全球范围内甲状腺癌的发病率呈上升趋势。甲状腺癌发病率的上升几乎完全归因于甲状腺乳头状癌的增加。上升的原因是复杂的、多因素的,且尚未完全了解。最明显的原因是诊断实体的使用增加、甲状腺肿瘤分类的改变,以及肥胖、环境危险因素和辐射等因素。经过治疗,甲状腺乳头状癌患者的预后通常良好。然而,癌症复发和第二原发癌的合并症可能会发生,因此了解甲状腺乳头状癌的临床、病理和分子参数非常重要。

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