Differentiated thyroid cancer (DTC) is the most prevalent endocrine malignancy in the world. Accurate diagnosis and prognostication are essential for optimizing its treatment and improving patient outcomes. This narrative review explores the diagnostic and prognostic histopathological, immunohistochemical, molecular, and genetic biomarkers in DTC, emphasizing their role in risk stratification and personalized management. Histopathological biomarkers, including tumor size, extrathyroidal extension, lymphovascular invasion, and aggressive subtypes (e.g., tall cell, hobnail, and insular variants), correlate with poor prognosis. Additionally, genetic alterations such asBRAF:p.V600E,RASmutations,TERTpromoter mutations, andRET/PTCrearrangements provide molecular insights into tumor progression and therapeutic response. Some of these molecular/genetic mutations have surrogate proteins that are feasible for immunohistochemical analysis, providing faster and cost-effective alternatives. Advances in next-generation sequencing have further refined risk stratification, facilitating precision medicine approaches. Future research should focus on validating novel biomarkers and developing targeted therapies to improve patient outcomes.
分化型甲状腺癌是全球最常见的内分泌系统恶性肿瘤。精确诊断与预后评估对于优化治疗方案、改善患者预后至关重要。本文综述了分化型甲状腺癌诊断与预后相关的组织病理学、免疫组化、分子及遗传生物标志物，重点探讨其在风险分层和个体化治疗中的作用。组织病理学标志物（包括肿瘤大小、甲状腺外侵犯、淋巴血管浸润及侵袭性亚型如高细胞型、鞋钉样型及岛状变异型）与不良预后密切相关。此外，BRAF:p.V600E、RAS突变、TERT启动子突变及RET/PTC重排等基因改变为肿瘤进展和治疗反应提供了分子层面的见解。部分分子/遗传突变存在可通过免疫组化检测的替代蛋白标志物，为临床提供了更快速、经济的检测方案。新一代测序技术的进步进一步优化了风险分层体系，推动了精准医疗的发展。未来研究应聚焦于验证新型生物标志物并开发靶向疗法，以提升患者临床结局。
肿瘤(癌症)患者之家