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关于当前诊断和治疗形甲状腺癌的最新情况
Efstathios T Pavlidis1, Ioannis N Galanis1, Theodoros E Pavlidis2
12nd Propedeutic Department of Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece.
World journal of clinical oncology
|January 5, 2024
概括
无塑性甲状腺癌是侵略性的,结果不好. 针对性治疗,如BRAF/MEK抑制剂,与手术相结合,显著提高了生存率,为患者提供了新的希望.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 分子生物学分子生物学
背景情况:
- 无塑性甲状腺癌 (ATC) 是一种罕见的 (<0.2%),但极具攻击性的甲状腺癌亚型.
- ATC呈现出阴暗的预后,快速进展,并由于呼吸道阻塞和消化不良等症状,显著影响生活质量.
- 早期诊断和准确的分期对于管理这种侵袭性恶性瘤至关重要.
研究的目的:
- 审查当前的诊断工具和形甲状腺癌中的分子因素.
- 探索ATC的新和新兴的治疗策略.
- 突出针对性疗法和免疫治疗对患者结果的影响.
主要方法:
- 对包括活检,成像 (超声波,CT,MRI,PET/CT) 和液体活检在内的诊断方式的审查.
- 对诸如BRAF (V600E),RET,KRAS,HRAS和NRAS等常见基因突变的分析.
- 评估治疗策略,包括手术,化疗,放射治疗,向药物和免疫治疗.
主要成果:
- BRAF-V600E突变是ATC的一个关键分子驱动器.
- 与BRAF抑制剂dabrafenib和MEK抑制剂trametinib的联合治疗显示出显著的疗效,FDA批准了BRAF-V600E突变病例.
- 在选定的患者中,经过手术后的新辅助向治疗实现了80%的两年总生存率.
- 年轻的年龄,早期的瘤阶段和放射治疗与改善的结果有关.
结论:
- 无塑性甲状腺癌需要多学科和个性化的治疗方法.
- 新型向疗法和免疫疗法代表了管理ATC的有希望的进步.
- 基因分析和先进治疗模式的结合为ATC患者提供了更好的生存率和生活质量.
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