Zhang Junsi, Xu Sunwang
Department of Thyroid and Breast Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Thyroid and Breast Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Cell Death Discov. 2024 Aug 26;10(1):378. doi: 10.1038/s41420-024-02157-2.
The global incidence of thyroid cancer has increased over recent decades. Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and accounts for nearly 90% of all cases. Typically, PTC has a good prognosis. However, some PTC variants exhibit more aggressive behaviour, which significantly increases the risk of postoperative recurrence. Over the past decade, the high metastatic potential of PTC has drawn the attention of many researchers and these studies have provided useful molecular markers for improved diagnosis, risk stratification and clinical approaches. The aim of this review is to discuss the progress in epidemiology, metastatic features, risk factors and molecular mechanisms associated with PTC aggressiveness. We present a detailed picture showing that epithelial-to-mesenchymal transition, cancer metabolic reprogramming, alterations in important signalling pathways, epigenetic aberrations and the tumour microenvironment are crucial drivers of PTC metastasis. Further research is needed to more fully elucidate the pathogenesis and biological behaviour underlying the aggressiveness of PTC.
近几十年来，全球甲状腺癌的发病率有所上升。乳头状甲状腺癌（PTC）是最常见的甲状腺癌类型，占所有病例的近90%。通常情况下，PTC的预后良好。然而，一些PTC变体表现出更具侵袭性的行为，这显著增加了术后复发的风险。在过去十年中，PTC的高转移潜能引起了许多研究人员的关注，这些研究为改进诊断、风险分层和临床方法提供了有用的分子标志物。这篇综述的目的是讨论与PTC侵袭性相关的流行病学、转移特征、危险因素和分子机制方面的进展。我们展示了一幅详细的图景，表明上皮-间质转化、癌症代谢重编程、重要信号通路的改变、表观遗传异常和肿瘤微环境是PTC转移的关键驱动因素。需要进一步研究以更全面地阐明PTC侵袭性背后的发病机制和生物学行为。
