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间变性甲状腺癌的当代诊断与管理方法概述。

An overview of the contemporary diagnosis and management approaches for anaplastic thyroid carcinoma.

作者信息

Zhou Shu-Yue, Luo Lian-Xiang

机构信息

The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China.

The Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China.

出版信息

World J Clin Oncol. 2024 Jun 24;15(6):674-676. doi: 10.5306/wjco.v15.i6.674.

Abstract

Thyroid carcinoma is a complex disease with several types, the most common being well-differentiated and undifferentiated. The latter, "undifferentiated carcinoma", also known as anaplastic thyroid carcinoma (ATC), is a highly aggressive malignant tumor accounting for less than 0.2% of all thyroid carcinomas and carries a poor prognosis with a median survival of 5 months. gene mutations are the most common molecular factor associated with this type of thyroid carcinoma. Recent advances in targeted biological agents, immunotherapy, stem cell therapy, nanotechnology, the dabrafenib/trametinib combination therapy, immune checkpoint inhibitors (ICI) and artificial intelligence offer novel treatment options. The combination therapy of dabrafenib and trametinib is the current standard treatment for patients with gene mutations. Besides, the dabrafenib/trametinib combination therapy, ICI, used alone or in combination with targeted therapies have raised some hopes for improving the prognosis of this deadly disease. Younger age, earlier tumor stage and radiotherapy are all prognostic factors for improved outcomes. Ultimately, therapeutic regimens should be tailored to the individual patient based on surveillance and epidemiological data, and a multidisciplinary approach is essential.

摘要

甲状腺癌是一种复杂的疾病,有多种类型,最常见的是高分化和未分化型。后者,即“未分化癌”,也称为间变性甲状腺癌(ATC),是一种侵袭性很强的恶性肿瘤,占所有甲状腺癌的比例不到0.2%,预后很差,中位生存期为5个月。基因突变是与这种类型甲状腺癌相关的最常见分子因素。靶向生物制剂、免疫疗法、干细胞疗法、纳米技术、达拉非尼/曲美替尼联合疗法、免疫检查点抑制剂(ICI)和人工智能的最新进展提供了新的治疗选择。达拉非尼和曲美替尼联合疗法是目前针对有基因突变患者的标准治疗方法。此外,达拉非尼/曲美替尼联合疗法、ICI单独使用或与靶向疗法联合使用,为改善这种致命疾病的预后带来了一些希望。较年轻的年龄、较早的肿瘤分期和放疗都是预后改善的因素。最终,应根据监测和流行病学数据为个体患者量身定制治疗方案,多学科方法至关重要。

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