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甲状腺癌中的NTRK融合:病理学及临床方面

NTRK fusions in thyroid cancer: Pathology and clinical aspects.

作者信息

Ma Yanhui, Zhang Qi, Zhang Kexin, Liang Yunzi, Ren Fangbing, Zhang Jingwen, Kan Chengxia, Han Fang, Sun Xiaodong

机构信息

Department of Endocrinology and Metabolism, Affiliated Hospital of Weifang Medical University, Weifang, China; Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China; Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang, China.

Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang, China.

出版信息

Crit Rev Oncol Hematol. 2023 Apr;184:103957. doi: 10.1016/j.critrevonc.2023.103957. Epub 2023 Mar 11.

Abstract

Thyroid cancer is the most common endocrine cancer. Neurotrophic tyrosine receptor kinase (NTRK) fusions are oncogenic drivers in multiple solid tumors, including thyroid cancer. NTRK fusion thyroid cancer has unique pathological features such as mixed structure, multiple nodes, lymph node metastasis, and a background of chronic lymphocytic thyroiditis. Currently, RNA-based next-generation sequencing is the gold standard for the detection of NTRK fusions. Tropomyosin receptor kinase inhibitors have shown promising efficacy in patients with NTRK fusion-positive thyroid cancer. Efforts to overcome acquired drug resistance are the focus of research concerning next-generation TRK inhibitors. However, there are no authoritative recommendations or standardized procedures for the diagnosis and treatment of NTRK fusions in thyroid cancer. This review discusses current research progress regarding NTRK fusion-positive thyroid cancer, summarizes the clinicopathological features of the disease, and outlines the current statuses of NTRK fusion detection and targeted therapeutic agents.

摘要

甲状腺癌是最常见的内分泌癌。神经营养性酪氨酸受体激酶(NTRK)融合是包括甲状腺癌在内的多种实体瘤的致癌驱动因素。NTRK融合甲状腺癌具有独特的病理特征,如混合结构、多结节、淋巴结转移以及慢性淋巴细胞性甲状腺炎背景。目前,基于RNA的下一代测序是检测NTRK融合的金标准。原肌球蛋白受体激酶抑制剂在NTRK融合阳性甲状腺癌患者中已显示出有前景的疗效。克服获得性耐药的努力是下一代TRK抑制剂研究的重点。然而,对于甲状腺癌中NTRK融合的诊断和治疗,尚无权威性建议或标准化程序。本综述讨论了NTRK融合阳性甲状腺癌的当前研究进展,总结了该疾病的临床病理特征,并概述了NTRK融合检测和靶向治疗药物的现状。

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