文章：

甲状腺滤泡细胞瘤的发病机制

Pathogenetic mechanisms in thyroid follicular-cell neoplasia

原文发布日期：2006-04-01

DOI: 10.1038/nrc1836

类型: Review Article

开放获取: 否

要点：

1. Thyroid tumours are the most common malignancy of endocrine organs, and incidence rates have steadily increased over recent decades.
2. Most carcinomas that are derived from follicular epithelial cells are indolent tumours that can be effectively managed. However, a subset of these tumours can behave aggressively, and there is currently no effective form of treatment.
3. Radiation exposure, iodine intake, lymphocytic thyroiditis, hormonal factors and family history all alter the risk of thyroid carcinoma.
4. Alterations in key signalling effectors seem to be the hallmark of distinct forms of thyroid neoplasia.
5. Mutations or rearrangements that involve mitogen-activated protein kinase (MAPK)-pathway effectors seem to be required for transformation.
6. Signalling through growth factors and their receptors is considered essential for cancer progression, and some of these growth factors have been identified as modifiers of the behaviour of transformed thyroid cells.
7. Cell-cycle regulators and adhesion molecules are altered in thyroid carcinomas, typically through epigenetic mechanisms that indicate progression to poorly differentiated or undifferentiated forms.
8. Several molecules that are involved in the pathogenesis of thyroid cancers are emerging as diagnostic and/or prognostic tools for patient management.

要点翻译：

1. 甲状腺肿瘤是内分泌器官中最常见的恶性肿瘤，近几十年来其发病率持续上升。
2. 大多数来源于滤泡上皮细胞的癌属于惰性肿瘤，可通过有效手段进行控制。然而，其中部分肿瘤可能具有侵袭性行为，目前尚无有效的治疗方案。
3. 辐射暴露、碘摄入量、淋巴细胞性甲状腺炎、激素因素及家族史均会改变甲状腺癌的患病风险。
4. 关键信号效应分子的改变似乎是不同类型甲状腺肿瘤的标志性特征。
5. 涉及丝裂原活化蛋白激酶通路效应器的突变或重排似乎是细胞转化所必需的条件。
6. 生长因子及其受体的信号传导被认为对癌症进展至关重要，其中部分生长因子已被证实能够改变转化后甲状腺细胞的行为特征。
7. 细胞周期调节因子和黏附分子在甲状腺癌中发生改变——通常通过表观遗传机制，这标志着肿瘤向低分化或未分化形式的进展。
8. 多种参与甲状腺癌发病机制的分子正逐渐成为患者诊疗中的诊断和/或预后工具。

英文摘要：

Thyroid cancer is one of the few malignancies that are increasing in incidence. Recent advances have improved our understanding of its pathogenesis; these include the identification of genetic alterations that activate a common effector pathway involving the RET–Ras–BRAF signalling cascade, and other unique chromosomal rearrangements. Some of these have been associated with radiation exposure as a pathogenetic mechanism. Defects in transcriptional and post-transcriptional regulation of adhesion molecules and cell-cycle control elements seem to affect tumour progression. This information can provide powerful ancillary diagnostic tools and can also be used to identify new therapeutic targets.

摘要翻译： 

甲状腺癌是少数发病率正在上升的恶性肿瘤之一。最新进展加深了我们对该病发病机制的认识；这些进展包括发现可激活共同效应通路（即RET–Ras–BRAF信号级联）的基因改变，以及其他独特的染色体重排。其中某些改变与辐射暴露作为致病机制有关。黏附分子和细胞周期调控元件在转录及转录后水平的缺陷，似乎会影响肿瘤的进展。这些信息不仅能提供有力的辅助诊断工具，也可用于发现新的治疗靶点。

原文链接：

Pathogenetic mechanisms in thyroid follicular-cell neoplasia