RAS-positive thyroid nodules

被引:19
作者
Angell, Trevor E. [1 ,2 ]
机构
[1] Brigham & Womens Hosp, Div Endocrinol Diabet & Hypertens, Thyroid Sect, 77 Louis Pasteur Ave,HIM 641, Boston, MA 02115 USA
[2] Harvard Med Sch, 77 Louis Pasteur Ave,HIM 641, Boston, MA 02115 USA
关键词
follicular variant of papillary thyroid carcinoma; indeterminate; molecular; neoplasm with papillary-like nuclear features; RAS; thyroid nodule; TERT PROMOTER MUTATIONS; FOLLICULAR VARIANT; CANCER; DIAGNOSIS; NEOPLASM; ASSOCIATION; EXPRESSION; GUIDELINES; MANAGEMENT; CARCINOMA;
D O I
10.1097/MED.0000000000000354
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of reviewThe current review focuses on the uncertainty regarding the management of rat sarcoma viral oncogene homolog RAS-positive thyroid nodules. The application of oncogene testing has been heralded for improving risk assessment for indeterminate cytology thyroid nodules and has grown in clinical use. RAS mutations are historically considered oncogenic. However, RAS mutation detection in thyroid nodules has proven problematic, as these mutations are found in benign and malignant lesions.Recent findingsRAS-positive thyroid nodules frequently have indeterminate cytology and a finding of a positive RAS mutation identifies a significant number of benign lesions as well as thyroid cancers. Long-term follow-up of RAS-positive nodules with benign cytology shows an indolent course not consistent with eventual malignant transformation. Many RAS-positive nodules previously diagnosed as follicular variant of papillary thyroid carcinoma now will be reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features, indicating a more indolent nature of these RAS-positive lesions.SummaryRecent findings have underscored that diagnosis of a RAS-positive thyroid nodule is not synonymous with thyroid malignancy. The ideal clinical and surgical management of these nodules remains challenging.
引用
收藏
页码:372 / 376
页数:5
相关论文
共 28 条
[1]   Integrated Genomic Characterization of Papillary Thyroid Carcinoma [J].
Agrawal, Nishant ;
Akbani, Rehan ;
Aksoy, B. Arman ;
Ally, Adrian ;
Arachchi, Harindra ;
Asa, Sylvia L. ;
Auman, J. Todd ;
Balasundaram, Miruna ;
Balu, Saianand ;
Baylin, Stephen B. ;
Behera, Madhusmita ;
Bernard, Brady ;
Beroukhim, Rameen ;
Bishop, Justin A. ;
Black, Aaron D. ;
Bodenheimer, Tom ;
Boice, Lori ;
Bootwalla, Moiz S. ;
Bowen, Jay ;
Bowlby, Reanne ;
Bristow, Christopher A. ;
Brookens, Robin ;
Brooks, Denise ;
Bryant, Robert ;
Buda, Elizabeth ;
Butterfield, Yaron S. N. ;
Carling, Tobias ;
Carlsen, Rebecca ;
Carter, Scott L. ;
Carty, Sally E. ;
Chan, Timothy A. ;
Chen, Amy Y. ;
Cherniack, Andrew D. ;
Cheung, Dorothy ;
Chin, Lynda ;
Cho, Juok ;
Chu, Andy ;
Chuah, Eric ;
Cibulskis, Kristian ;
Ciriello, Giovanni ;
Clarke, Amanda ;
Clayman, Gary L. ;
Cope, Leslie ;
Copland, John A. ;
Covington, Kyle ;
Danilova, Ludmila ;
Davidsen, Tanja ;
Demchok, John A. ;
DiCara, Daniel ;
Dhalla, Noreen .
CELL, 2014, 159 (03) :676-690
[2]  
[Anonymous], BETHESDA SYSTEM REPO
[3]  
Cibas ES., 2009, AM J CLIN PATHOL, V132, P658
[4]   AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES-2016 UPDATE [J].
Gharib, Hossein ;
Papini, Enrico ;
Garber, Jeffrey R. ;
Duick, Daniel S. ;
Harrell, R. Mack ;
Hegedus, Laszlo ;
Paschke, Ralf ;
Valcavi, Roberto ;
Vitti, Paolo .
ENDOCRINE PRACTICE, 2016, 22 :1-60
[5]   2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer [J].
Haugen, Bryan R. ;
Alexander, Erik K. ;
Bible, Keith C. ;
Doherty, Gerard M. ;
Mandel, Susan J. ;
Nikiforov, Yuri E. ;
Pacini, Furio ;
Randolph, Gregory W. ;
Sawka, Anna M. ;
Schlumberger, Martin ;
Schuff, Kathryn G. ;
Sherman, Steven I. ;
Sosa, Julie Ann ;
Steward, David L. ;
Tuttle, R. Michael ;
Wartofsky, Leonard .
THYROID, 2016, 26 (01) :1-133
[6]   RAS Mutations in Thyroid Cancer [J].
Howell, Gina M. ;
Hodak, Steven P. ;
Yip, Linwah .
ONCOLOGIST, 2013, 18 (08) :926-932
[7]   The Increase in Thyroid Cancer Incidence During the Last Four Decades Is Accompanied by a High Frequency of BRAF Mutations and a Sharp Increase in RAS Mutations [J].
Jung, Chan Kwon ;
Little, Mark P. ;
Lubin, Jay H. ;
Brenner, Alina V. ;
Wells, Samuel A., Jr. ;
Sigurdson, Alice J. ;
Nikiforov, Yuri E. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2014, 99 (02) :E276-E285
[8]   Coming to terms with NIFTP: A provisional approach for cytologists [J].
Krane, Jeffrey F. ;
Alexander, Erik K. ;
Cibas, Edmund S. ;
Barletta, Justine A. .
CANCER CYTOPATHOLOGY, 2016, 124 (11) :767-772
[9]   TERT promoter mutations in thyroid cancer [J].
Liu, Rengyun ;
Xing, Mingzhao .
ENDOCRINE-RELATED CANCER, 2016, 23 (03) :R143-R155
[10]   The variable phenotype and low-risk nature of RAS-positive thyroid nodules [J].
Medici, Marco ;
Kwong, Norra ;
Angell, Trevor E. ;
Marqusee, Ellen ;
Kim, Matthew I. ;
Frates, Mary C. ;
Benson, Carol B. ;
Cibas, Edmund S. ;
Barletta, Justine A. ;
Krane, Jeffrey F. ;
Ruan, Daniel T. ;
Cho, Nancy L. ;
Gawande, Atul A. ;
Moore, Francis D., Jr. ;
Alexander, Erik K. .
BMC MEDICINE, 2015, 13