Translating the desmoplastic microenvironment of medullary thyroid cancer into surgical practice.

IF 2.9 3区医学 Q2 Medicine Endocrine Pub Date : 2025-02-01 Epub Date: 2024-09-30 DOI:10.1007/s12020-024-04060-3

Andreas Machens, Henning Dralle

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Abstract

Purpose: The tumor microenvironment often induces a scarring process known as tumor fibrosis or desmoplasia, which plays an important role in the initiation, progression, and clinical outcome of many types of cancer. This report aimed to highlight recent progress made in the field of de-escalation surgery for sporadic medullary thyroid cancer (MTC), building a bridge from basic science to current and emerging medical practice.

Methods: This narrative review entails a holistic description and interpretation of the English-language literature on MTC desmoplasia.

Results: Absence of primary tumor desmoplasia on intraoperative frozen section and definitive histopathology goes hand in hand with absence of node metastases in up to one-third of patients with sporadic MTC. Patients with desmoplasia-negative MTC require no more than hemithyroidectomy for cure.

Conclusion: Thyroid desmoplasia is a powerful predictive tissue biomarker for the intraoperative management of patients with sporadic MTC, outpacing conventional tumor classification systems that depend on definitive histopathology.

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将甲状腺髓样癌的脱鳞微环境转化为手术实践。

目的：肿瘤微环境通常会诱发一种被称为肿瘤纤维化或脱钙的瘢痕形成过程，它在多种癌症的发生、发展和临床预后中发挥着重要作用。本报告旨在重点介绍散发性甲状腺髓样癌去势手术领域的最新进展，为基础科学与当前和新兴的医疗实践搭建一座桥梁：这篇叙事性综述全面描述和解读了有关MTC脱髓鞘的英文文献：多达三分之一的散发性 MTC 患者在术中冰冻切片和明确组织病理学检查中没有发现原发肿瘤脱落细胞，同时也没有结节转移。脱落细胞阴性的 MTC 患者只需进行甲状腺半切除术即可治愈：甲状腺脱落细胞是散发性 MTC 患者术中管理的一个强大的预测性组织生物标志物，它超越了依赖于明确组织病理学的传统肿瘤分类系统。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.