Journal
ENDOCRINE PATHOLOGY
Volume 32, Issue 1, Pages 44-62Publisher
HUMANA PRESS INC
DOI: 10.1007/s12022-021-09666-1
Keywords
Thyroid cancer; BRAF; TERT Prognosis; Outcome
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Funding
- FEDER-Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020-Operacional Programme for Competitiveness and Internationalization (POCI), Portugal 2020
- Portuguese funds through FCT-Fundacao para a Ciencia e a Tecnologia/Ministerio da Ciencia, Tecnologia e Inovacao [POCI-01-0145-FEDER-007274]
- European Regional Development Fund (ERDF) through the Operational Programme for Competitiveness and Internationalization-COMPETE2020
- Portuguese national funds via FCT [POCI-01-0145-FEDER-016390]
- FCT [POCI-01-0145-FEDER-031438, PDTC/MED_ONC/31438/2017, CEECIND/00201/2017]
- Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo-Bolsa SPEDM para projecto de investigacao
- Instituto de Salud Carlos III, Ministry of Science and Innovation, Spain [ISCIII-PI19/01316FEDER]
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This review discusses the impact of molecular alterations on the diagnosis and prognosis of differentiated thyroid carcinoma (DTC) and highlights the roles of BRAF V600E and TERT promoter (TERTp) mutations in risk stratification. It also explores the molecular changes in different subtypes, providing valuable insights for the clinical management of thyroid cancer.
This review addresses the impact of molecular alterations on the diagnosis and prognosis of differentiated thyroid carcinoma (DTC), including papillary, follicular, and well-differentiated carcinoma NOS, as well as oncocytic neoplasms. The molecular characterization of DTC is based upon the well-established dichotomy of BRAF-like and RAS-like designations, together with a remaining third group, less homogeneous, composed of non-BRAF-/non-RAS-like tumors. The role of BRAF V600E mutation in risk stratification is discussed in the clinico-pathological context, namely, staging and invasive features of classic papillary thyroid carcinoma (PTC) and histopathological variants carrying an excellent prognosis (microPTC) or a guarded prognosis, including the aggressive variants tall cell and hobnail cell PTCs. In follicular patterned tumors, namely, follicular thyroid carcinoma (FTC), with or without oncocytic features, the most prevalent molecular alteration are RAS mutations that do not carry prognostic significance. The only genetic alteration that has been proven to play a role in risk stratification of PTC and FTC is TERT promoter (TERTp) mutation.
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