甲状腺癌的分型及其分子发病机制研究进展  

Classification of thyroid cancer and its molecular pathogenesis

作　　者：赵海月[1] 宋旸[2] 沈迪寒 杨麒巍 陈香润[2] 冯琳琳[3] 张桂珍[1,2] 

机构地区：[1]吉林大学第二医院中心实验室 [2]吉林大学第二医院骨科 [3]吉林大学第二医院检验科,长春130041

出　　处：《中国体视学与图像分析》2017年第4期465-471,共7页Chinese Journal of Stereology and Image Analysis

基　　金：吉林省卫计委项目(20132003);吉林大学白求恩基金项目(2015409);吉林省科技厅项目(20140311066YY;2015032022ZG);吉林省发改委项目(2014G073);吉林省教育厅项目(JJKH20170853KJ);国家自然科学基金项目(81702195)

摘　　要：近几十年来,甲状腺癌的发病率急剧上升。已知RAS,BRAF,RET/PTC,p53和Notch等基因均在甲状腺癌细胞的增殖和分化过程中起到重要的调控作用,这些基因在分化型甲状腺癌、甲状腺髓样癌和未分化甲状腺癌中的表达存在明显差异。分化型甲状腺癌中常见BRAF V600E突变,存在不同比例的NRAS、KRAS等。甲状腺髓样癌分为遗传性和散发性,RET原癌基因重排可能是导致遗传性发病的原因而散发性患者的病因尚不清楚。未分化甲状腺癌中FOXD3的低表达导致细胞凋亡被抑制,p53突变增加其侵袭能力。基因表达的差异可能也是导致甲状腺癌不同组织学类型临床特征和预后不同的关键性因素,因此深入了解不同组织学类型甲状腺癌的分子发病机制差异有助于甲状腺癌患者的个体精准化治疗。本文对分化型甲状腺癌、甲状腺髓样癌及甲状腺未分化癌及其分子发病机制进行综述。In recent decades,the incidence of thyroid cancer has increased significantly. It is known thatRAS,BRAF,RET/PTC,p53 and Notch play important roles in regulating the proliferation and differentiation of cells in thyroid carcinomas. These genes have significantly different expression in differentiated thyroid cancer,medullary thyroid carcinoma and undifferentiated thyroid cancer. BRAF V600E mutation is common in differentiated thyroid carcinomas with different ratios of NRAS and KRAS. Medullary thyroid cancer is divided into hereditary and sporadic. RET proto-oncogene rearrangement may be the cause leading to hereditary medullary thyroid carcinoma and the cause of sporadic patients is unclear. Low expression of FOXD3 in undifferentiated thyroid cancer leads to the inhibition of apoptosis and p53 mutation increases its invasiveness. Differences in gene expression may also contribute to the different clinical characteristics and prognosis of different histological types of thyroid cancer. Therefore,it is of great importance to understand the molecular pathogenesis of thyroid cancer in different histological types to help the individual treatment of thyroid cancer. This paper reviews the pathogenesis of differentiated thyroid carcinoma,medullary thyroid carcinoma,and undifferentiated thyroid carcinoma,as well as their molecular pathogenesis.

关 键 词：甲状腺癌 组织学分型 分子机制 

分 类 号：R736.1[医药卫生—肿瘤]