Wu Howard Her-Juing, Hou Tieying
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Kaohsiung J Med Sci. 2025 Jun;41(6):e70051. doi: 10.1002/kjm2.70051. Epub 2025 May 31.
Over the past few years, follicular-patterned thyroid nodules with nuclear features of papillary thyroid carcinoma (PTC) have been further subclassified based on molecular profiling, histologic features, and clinical behavior. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs) was established as a distinct entity in the 2017 4th edition of the WHO Classification of Tumors of Endocrine Organs due to its indolent clinical behavior and excellent prognosis. These tumors are characterized by a well-defined border, an exclusive follicular growth pattern, and PTC nuclear features. Molecularly, NIFTPs typically harbor RAS gene mutations, PAX8-PPARG rearrangements, or THADA gene fusions. In the 2022 5th edition of the WHO Classification, subcentimeter NIFTPs and oncocytic NIFTPs were introduced as new subtypes. In this review, we summarize the epidemiology, ultrasound features, histology/cytology, and molecular characteristics of NIFTP. As research continues to refine diagnostic criteria and management approaches, recognizing the distinct molecular and clinical features of NIFTP is essential for optimizing patient care and ensuring appropriate surgical management.
在过去几年中，具有甲状腺乳头状癌（PTC）核特征的滤泡型甲状腺结节已根据分子特征、组织学特征和临床行为进一步细分。具有乳头状样核特征的非侵袭性滤泡性甲状腺肿瘤（NIFTP）因其惰性的临床行为和良好的预后，在2017年第4版世界卫生组织内分泌器官肿瘤分类中被确立为一个独特的实体。这些肿瘤的特征是边界清晰、独特的滤泡生长模式和PTC核特征。在分子层面，NIFTP通常携带RAS基因突变、PAX8-PPARG重排或THADA基因融合。在2022年第5版世界卫生组织分类中，亚厘米级NIFTP和嗜酸细胞性NIFTP被引入作为新的亚型。在本综述中，我们总结了NIFTP的流行病学、超声特征、组织学/细胞学和分子特征。随着研究不断完善诊断标准和管理方法，认识到NIFTP独特的分子和临床特征对于优化患者护理和确保适当的手术管理至关重要。
