Li Xiaoxiao, Han Hengtong, Yang Kaili, Li Shouhua, Ma Libin, Yang Ze, Zhao Yong-Xun
The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.
The Seventh Department of General Surgery, Department of Thyroid Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
Front Immunol. 2024 Dec 24;15:1476427. doi: 10.3389/fimmu.2024.1476427. eCollection 2024.
Thyroid cancer has become the most common endocrine malignancy. Although the majority of differentiated thyroid cancers have a favorable prognosis, advanced thyroid cancers, iodine-refractory thyroid cancers, and highly malignant undifferentiated carcinomas still face a serious challenge of poor prognosis and even death. Cancer stem cells are recognized as one of the central drivers of tumor evolution, recurrence and treatment resistance. A fresh viewpoint on the oncological aspects of thyroid cancer, including proliferation, invasion, recurrence, metastasis, and therapeutic resistance, has been made possible by the recent thorough understanding of the defining and developing features as well as the plasticity of thyroid cancer stem cells (TCSCs). The above characteristics of TCSCs are complicated and regulated by cell-intrinsic mechanisms (including activation of key stem signaling pathways, somatic cell dedifferentiation, etc.) and cell-extrinsic mechanisms. The complex communication between TCSCs and the infiltrating immune cell populations in the tumor microenvironment (TME) is a paradigm for cell-extrinsic regulators. This review introduces the current advances in the studies of TCSCs, including the origin of TCSCs, the intrinsic signaling pathways regulating the stemness of TCSCs, and emerging biomarkers; We further highlight the underlying principles of bidirectional crosstalk between TCSCs and immune cell populations driving thyroid cancer progression, recurrence, or metastasis, including the specific mechanisms by which immune cells maintain the stemness and other properties of TCSCs and how TCSCs reshape the immune microenvironmental landscape to create an immune evasive and pro-tumorigenic ecological niche. Finally, we outline promising strategies and challenges for targeting key programs in the TCSCs-immune cell crosstalk process to treat thyroid cancer.
甲状腺癌已成为最常见的内分泌系统恶性肿瘤。尽管大多数分化型甲状腺癌预后良好,但晚期甲状腺癌、碘难治性甲状腺癌以及高恶性未分化癌仍面临预后不良甚至死亡的严峻挑战。癌症干细胞被认为是肿瘤进展、复发和治疗抵抗的核心驱动因素之一。最近对甲状腺癌干细胞(TCSCs)的定义、发展特征以及可塑性的深入了解,为甲状腺癌在增殖、侵袭、复发、转移和治疗抵抗等肿瘤学方面带来了新的视角。TCSCs的上述特征复杂,受细胞内在机制(包括关键干细胞信号通路的激活、体细胞去分化等)和细胞外在机制的调控。TCSCs与肿瘤微环境(TME)中浸润的免疫细胞群体之间的复杂相互作用是细胞外在调节因子的一个范例。本综述介绍了TCSCs研究的当前进展,包括TCSCs的起源、调节TCSCs干性的内在信号通路以及新出现的生物标志物;我们进一步强调了TCSCs与驱动甲状腺癌进展、复发或转移的免疫细胞群体之间双向串扰的潜在机制,包括免疫细胞维持TCSCs干性和其他特性的具体机制,以及TCSCs如何重塑免疫微环境格局以创造一个免疫逃逸和促肿瘤发生的生态位。最后,我们概述了针对TCSCs - 免疫细胞串扰过程中的关键程序治疗甲状腺癌的有前景的策略和挑战。
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