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甲状腺癌:流行病学、分类、危险因素、诊断和预后标志物以及当前的治疗策略。

Thyroid Cancer: Epidemiology, Classification, Risk Factors, Diagnostic and Prognostic Markers, and Current Treatment Strategies.

作者信息

Forma Alicja, Kłodnicka Karolina, Pająk Weronika, Flieger Jolanta, Teresińska Barbara, Januszewski Jacek, Baj Jacek

机构信息

Department of Forensic Medicine, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090 Lublin, Poland.

Department of Correct, Clinical, and Imaging Anatomy, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland.

出版信息

Int J Mol Sci. 2025 May 28;26(11):5173. doi: 10.3390/ijms26115173.

Abstract

Thyroid cancer (TC) invariably remains the most prevalent endocrine cancer in the world. Major histological forms of TC include papillary (PTC), follicular (FTC), medullary (MTC), and anaplastic thyroid carcinoma (ATC), each of which has a unique clinical and molecular profile. The incidence rate of TC is higher in females, and unfortunately, it has tended to increase over the last several years. Yet the treatment of advanced or aggressive TC forms has improved recently because of developments in immunotherapy and targeted medicines, including PD-1 inhibitors and tyrosine kinase inhibitors (e.g., lenvatinib, sorafenib). Imaging, fine-needle aspiration biopsies, and molecular testing are implemented in the diagnostic process, e.g., in search of mutations that might affect prognosis and provide the most successful treatment option. Chemotherapy, immunotherapy, radioactive iodine therapy (RAI), surgery (such as a total thyroidectomy), and molecularly targeted therapies are currently standard treatment modalities in TC. Optimizing patient outcomes requires better diagnostic precision and individualized treatment regimens based on the genetic profile and tumor subtype. To improve survival and quality of life, it is critical to comprehend the complex etiology of TC and the changing therapeutic landscape.

摘要

甲状腺癌(TC)始终是全球最常见的内分泌癌。甲状腺癌的主要组织学类型包括乳头状癌(PTC)、滤泡状癌(FTC)、髓样癌(MTC)和间变性甲状腺癌(ATC),每种类型都有独特的临床和分子特征。甲状腺癌的发病率在女性中较高,不幸的是,在过去几年中呈上升趋势。然而,由于免疫疗法和靶向药物(包括PD-1抑制剂和酪氨酸激酶抑制剂,如乐伐替尼、索拉非尼)的发展,晚期或侵袭性甲状腺癌的治疗最近有所改善。在诊断过程中会进行影像学检查、细针穿刺活检和分子检测,例如寻找可能影响预后并提供最成功治疗方案的突变。化疗、免疫疗法、放射性碘治疗(RAI)、手术(如全甲状腺切除术)和分子靶向治疗目前是甲状腺癌的标准治疗方式。优化患者预后需要更高的诊断精度以及基于基因特征和肿瘤亚型的个体化治疗方案。为了提高生存率和生活质量,了解甲状腺癌的复杂病因和不断变化的治疗格局至关重要。

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