老年人甲状腺癌的特征:基于最新的世卫组织分类的组织学亚型和TERT促进器突变分析
Myoung Ju Koh1, Songmi Noh2, Jin Kyong Kim3
1Department of Pathology, Dae Dong Hospital, Busan, Republic of Korea.
Annals of diagnostic pathology
|October 24, 2025
概括
端粒酶逆转录酶 (TERT) 促进子突变与老年患者的侵袭性甲状腺癌亚型有关. 这一发现有助于对患有甲状腺癌的老年人进行更好的风险分层和治疗决定.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 老年病的医生 老年病的医生
背景情况:
- 老年人 (≥70岁) 的甲状腺癌往往呈现出侵略性,因伴随疾病而造成治疗挑战.
- 了解老年人侵袭性甲状腺癌的分子驱动因素对于有效管理至关重要.
研究的目的:
- 在老年患者中,研究端粒酶逆转录酶 (TERT) 促进子突变与高危组织学亚型 (差差分化的甲状腺癌[PDTC]和高度分化的甲状腺癌[DHGTC]) 之间的关联.
- 为了将TERT突变与临床病理特征相关联,这些特征表明该人口群体的预后不佳.
主要方法:
- 对293名经过甲状腺切除术的老年患者 (≥70岁) 的回顾性分析.
- 收集临床病理学数据,包括TNM和AJCC分期.
- 使用热测序对TERT促进子突变的分子分析.
主要成果:
- 在15.0%的病例中发现了TERT促进子突变,并且与PDTC/DHGTC亚型有显著的关联.
- 有TERT突变的瘤较大,表现出更先进的T阶段,淋巴结转移率和远程复发率更高.
- TERT突变与线粒活性增加和瘤亡相关,表明具有攻击性行为.
结论:
- 在患有甲状腺癌的老年患者中,PDTC/DHGTC亚型和TERT促进子突变相对较为常见.
- 在这个高危人群中,TERT突变是攻击性瘤特征和不良预后的强有力的预测因素.
- 结合组织学和分子评估,包括TERT突变状态,可以提高老年甲状腺癌患者的预后准确性.
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