TY - JOUR
T1 - Update on Fundamental Mechanisms of Thyroid Cancer
AU - Prete, Alessandro
AU - Borges de Souza, Patricia
AU - Censi, Simona
AU - Muzza, Marina
AU - Nucci, Nicole
AU - Sponziello, Marialuisa
N1 - Funding Information:
We thank Prof. Francesco Frasca from the Endocrine Unit of the Department of Clinical and Experimental Medicine of Catania University, Italy; Prof. Efisio Puxeddu from the Internal Medicine and Endocrine and Metabolic Science Section of the Department of Medicine, University of Perugia, Italy; Prof. Mario Vitale from the Endocrine Unit, University of Salerno, Italy; and Prof. Rossella Elisei from the Endocrine Unit of the Department of Clinical and Experimental Medicine of Pisa University, Italy, for the invaluable contribution in preparing this manuscript.
Publisher Copyright:
© Copyright © 2020 Prete, Borges de Souza, Censi, Muzza, Nucci and Sponziello.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/3/13
Y1 - 2020/3/13
N2 - The incidence of thyroid cancer (TC) has increased worldwide over the past four decades. TC is divided into three main histological types: differentiated (papillary and follicular TC), undifferentiated (poorly differentiated and anaplastic TC), and medullary TC, arising from TC cells. This review discusses the molecular mechanisms associated to the pathogenesis of different types of TC and their clinical relevance. In the last years, progresses in the genetic characterization of TC have provided molecular markers for diagnosis, risk stratification, and treatment targets. Recently, papillary TC, the most frequent form of TC, has been reclassified into two molecular subtypes, named BRAF-like and RAS-like, associated to a different range of cancer risks. Similarly, the genetic characterization of follicular TC has been proposed to complement the new histopathological classification in order to estimate the prognosis. New analyses characterized a comprehensive molecular profile of medullary TC, raising the role of RET mutations. More recent evidences suggested that immune microenvironment associated to TC may play a critical role in tumor invasion, with potential immunotherapeutic implications in advanced and metastatic TC. Several types of ancillary approaches have been developed to improve the diagnostic value of fine needle aspiration biopsies in indeterminate thyroid nodules. Finally, liquid biopsy, as a non-invasive diagnostic tool for body fluid genotyping, brings a new prospective of disease and therapy monitoring. Despite all these novelties, much work remains to be done to fully understand the pathogenesis and biological behaviors of the different types of TC and to transfer this knowledge in clinical practice.
AB - The incidence of thyroid cancer (TC) has increased worldwide over the past four decades. TC is divided into three main histological types: differentiated (papillary and follicular TC), undifferentiated (poorly differentiated and anaplastic TC), and medullary TC, arising from TC cells. This review discusses the molecular mechanisms associated to the pathogenesis of different types of TC and their clinical relevance. In the last years, progresses in the genetic characterization of TC have provided molecular markers for diagnosis, risk stratification, and treatment targets. Recently, papillary TC, the most frequent form of TC, has been reclassified into two molecular subtypes, named BRAF-like and RAS-like, associated to a different range of cancer risks. Similarly, the genetic characterization of follicular TC has been proposed to complement the new histopathological classification in order to estimate the prognosis. New analyses characterized a comprehensive molecular profile of medullary TC, raising the role of RET mutations. More recent evidences suggested that immune microenvironment associated to TC may play a critical role in tumor invasion, with potential immunotherapeutic implications in advanced and metastatic TC. Several types of ancillary approaches have been developed to improve the diagnostic value of fine needle aspiration biopsies in indeterminate thyroid nodules. Finally, liquid biopsy, as a non-invasive diagnostic tool for body fluid genotyping, brings a new prospective of disease and therapy monitoring. Despite all these novelties, much work remains to be done to fully understand the pathogenesis and biological behaviors of the different types of TC and to transfer this knowledge in clinical practice.
KW - BRAF
KW - oncogenes
KW - RAS
KW - RET
KW - thyroid cancer
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U2 - 10.3389/fendo.2020.00102
DO - 10.3389/fendo.2020.00102
M3 - Review article
AN - SCOPUS:85082649106
VL - 11
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
SN - 1664-2392
M1 - 102
ER -