Su Jing-Yang, Huang Ting, Zhang Jia-Lin, Lu Jin-Hua, Wang Meng-Lei, Yan Jiang, Lin Ren-Bin, Lin Sheng-You, Wang Jue
Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University Hangzhou 310007, Zhejiang, China.
Tongde Hospital of Zhejiang Province Hangzhou 310012, Zhejiang, China.
Am J Cancer Res. 2024 Feb 15;14(2):407-428. doi: 10.62347/EJAA3388. eCollection 2024.
Thyroid cancer can be classified into three different types based on the degree of differentiation: well-differentiated, poorly differentiated, and anaplastic thyroid carcinoma. Well-differentiated thyroid cancer refers to cancer cells that closely resemble normal thyroid cells, while poorly differentiated and anaplastic thyroid carcinoma are characterized by cells that have lost their resemblance to normal thyroid cells. Advanced thyroid carcinoma, regardless of its degree of differentiation, is known to have a higher likelihood of disease progression and is generally associated with a poor prognosis. However, the process through which well-differentiated thyroid carcinoma transforms into anaplastic thyroid carcinoma, also known as "dedifferentiation", has been a subject of intensive research. In recent years, there have been significant breakthroughs in the treatment of refractory advanced thyroid cancer. Clinical studies have been conducted to evaluate the efficacy and safety of molecular targeted drugs and immune checkpoint inhibitors in the treatment of dedifferentiated thyroid cancer. These drugs work by targeting specific molecules or proteins in cancer cells to inhibit their growth or by enhancing the body's immune response against the cancer cells. This article aims to explore some of the possible mechanisms behind the dedifferentiation process in well-differentiated thyroid carcinoma. It also discusses the clinical effects of molecular targeted drugs and immune checkpoint inhibitors in thyroid cancer patients with different degrees of differentiation. Furthermore, it offers insights into the future trends in the treatment of advanced thyroid cancer, highlighting the potential for improved outcomes and better patient care.
高分化型、低分化型和未分化型甲状腺癌。高分化型甲状腺癌是指癌细胞与正常甲状腺细胞极为相似,而低分化型和未分化型甲状腺癌的特征是细胞已失去与正常甲状腺细胞的相似性。晚期甲状腺癌,无论其分化程度如何,已知疾病进展的可能性更高,且通常预后较差。然而,高分化型甲状腺癌转变为未分化型甲状腺癌的过程,即所谓的“去分化”,一直是深入研究的课题。近年来,难治性晚期甲状腺癌的治疗取得了重大突破。已开展临床研究以评估分子靶向药物和免疫检查点抑制剂在治疗去分化型甲状腺癌中的疗效和安全性。这些药物通过靶向癌细胞中的特定分子或蛋白质来抑制其生长,或通过增强机体对癌细胞的免疫反应发挥作用。本文旨在探讨高分化型甲状腺癌去分化过程背后的一些可能机制。还讨论了分子靶向药物和免疫检查点抑制剂在不同分化程度甲状腺癌患者中的临床效果。此外,还对晚期甲状腺癌治疗的未来趋势进行了探讨,强调了改善治疗效果和提高患者护理水平的潜力。