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目的:研究甲状腺癌分子生物学的进展为临床应用提供可靠的理论依据。方法:应用Medline、PubMed及CNKI期刊全文数据库检索系统,以“甲状腺癌、癌基因和分子标志”等为关键词,检索1990-2011年的相关文献。纳入标准:1)甲状腺癌发生发展过程中相关的分子生物学改变;2)分子生物学改变的检测技术和临床应用。符合要求纳入分析的文献32篇。结果:近年来的研究发现,在甲状腺癌的发生发展过程中涉及大量相关基因结构和表达调控的改变。其中研究较多且特异性强的分子标志包括BRAF、Ret/PTC、Ras和PAX8/PPARγ等。现今,甲状腺细针抽吸(fine-needle aspiration,FNA)活检技术已成为诊断结节性甲状腺疾病,鉴别肿瘤良恶性最为可行的方法之一。更为重要的是,对FNA样本进行基因突变检测已被证明可明显提高结节性甲状腺疾病细胞学诊断的准确度。结论:对FNA活检样本检测多位点甲状腺癌分子标志,将有助于结节性甲状腺疾病的病理诊断、治疗及预后评价。
Objective: To study the molecular biology of thyroid cancer and provide a reliable theoretical basis for clinical application. Methods: Using the Medline, PubMed and CNKI full-text database retrieval system, the relevant literature from 1990 to 2011 was retrieved with the key words of “thyroid cancer, oncogenes and molecular markers”. Inclusion criteria: 1) related molecular biology changes in the development of thyroid cancer; 2) molecular biological changes in detection techniques and clinical applications. 32 articles meeting the requirements for inclusion in the analysis. Results: In recent years, the study found that in the development of thyroid cancer involves a large number of related gene structure and expression of regulatory changes. Among the more studied and specific molecular markers include BRAF, Ret / PTC, Ras and PAX8 / PPARγ. Nowadays, fine-needle aspiration (FNA) biopsy technique has become one of the most feasible methods to diagnose nodular thyroid disease and differentiate benign and malignant tumors. More importantly, gene mutation testing of FNA samples has been shown to significantly improve the accuracy of cytologic diagnosis of nodular thyroid disease. Conclusion: The detection of multi-site thyroid cancer molecular markers by FNA biopsy samples will be helpful for pathological diagnosis, treatment and prognosis evaluation of nodular thyroid disease.