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在核心活检样本中对无塑性甲状腺癌的诊断评估:形态学,免疫学,分子学和治疗性考虑

Maria Cristina Riascos¹, Justine A Barletta²

¹Department of Pathology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.

Endocrine pathology

|September 4, 2025

概括

在核心活检上诊断出无塑性甲状腺癌 (ATC) 需要仔细考虑差异诊断和明智地使用免疫组织化学 (IHC). 包括BRAF V600E和PD- L1在内的生物标志物测试对于针对性治疗和ATC患者的免疫治疗选择至关重要.

科学领域:

癌症学
病理学
分子诊断

背景情况:

由于组织有限,在核心针活检上诊断甲状腺癌 (ATC) 可能具有挑战性.
准确的诊断需要区分ATC与其他甲状腺恶性瘤.
免疫组织化学 (IHC) 和分子测试对于最终的诊断和治疗计划至关重要.

研究的目的:

概述ATC的形态和免疫类型特征.
在核心活检上审查ATC的差异诊断.
突出ATC关键生物标志物的治疗影响.

主要方法:

对ATC的形态和免疫类型特征的审查.
差异诊断实体的分析
评估免疫组织化学 (IHC) 和分子测试 (下一代测序 - NGS) 的实用性.
对BRAF V600E,PD-L1,NTRK,RET,不匹配修复缺陷和瘤突变负担生物标志物的评估.

主要成果:

合理的IHC对于支持ATC诊断和排除模仿者至关重要.
在指导BRAF向治疗时,BRAF V600E突变测试至关重要.
NGS识别了BRAF野生型ATC的可操作变化,并评估了瘤突变负担.
对于BRAF V600E突变ATC,PD- L1表达指导免疫治疗选择,特别是与BRAF抑制剂结合使用.

结论:

在核心活检上确切的ATC诊断依赖于包括形态学,IHC和分子检测在内的全面评估.
生物标志物分析 (BRAF V600E,PD-L1等) 对于个性化治疗策略至关重要.
这一审查为ATC管理中整合诊断和治疗生物标志物评估提供了一个框架.

关键词:

甲状腺癌的发生在BRAF V600E 生物检查免疫组织化学其他类型

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