Tiroid Papiller Mikrokarsinomun Moleküler Özellikleri

Öz

Tiroid papiller karsinom (TPK) en sık görülen endokrin malignite olup tiroid kanserleri arasında en yaygın (%70-80) kanser türüdür. 10 mm ve daha küçük boyutta olan tiroid papiller karsinomları tiroid papiller mikrokarsinom (TPMK) olarak isimlendirilmektedir. Tiroid papiller mikrokarsinomları çoğu indolent tümörlerden oluşur ki bu tümörler düşük nüks riski ve mortalite oranlarına sahiptir. TPMK' ların cerrahi sonrası daha yüksek lokal nüks ve/veya uzak metastaz riski taşıyan, agresif seyirli bir alt grubu da bulunmaktadır. Agresif davranış ile ilişkili prognostik faktörler; 45 yaş üzeri olmak, erkek cinsiyet, tümör boyutunun 5 mm' den büyük olması, multifokalite, lenf nodu metastazı ve ekstra tiroidal yayılım bulunması şeklinde sıralanabilir. Tiroid karsinogenezinde, MAPK sinyal yolağının yapısal aktivasyonu temel rol oynamaktadır. Bu yolaktaki proteinler, reseptör tirozin kinazlar (VEGF, RET, ALK ve TRK' yı içeren RTK' lar), RAS, BRAF, MEK ve ERK' ten oluşmaktadır. MAPK sinyal yolağı, farklı tiroid karsinom alt türlerinin gelişiminde rol oynayan, hücre ptroliferasyonu, diferansiyasyon ve sağkalım ile ilişkili bir yolaktır.

Anahtar Kelimeler

• Tiroid karsinogenez
• MAPK sinyal yolağı
• prognostik belirteç

Molecular features of thyroid papillary microcarcinomas

Öz

Thyroid papillary carcinoma (TPC) is the most common endocrine malignancy and the most common (70-80%) type of cancer among thyroid cancers. Thyroid papillary carcinomas that are 10 mm or smaller in size are called thyroid papillary microcarcinoma (TPMC). Thyroid papillary microcarcinomas are mostly indolent tumors that have low recurrence risk and mortality rates. There is also a subgroup of TPMCs with an aggressive course that carries a higher risk of local recurrence and/or distant metastasis after surgery. Prognostic factors associated with aggressive behavior; They can be listed as being over 45 years of age, male gender, tumor size larger than 5 mm, multifocality, lymph node metastasis and extra-thyroidal spread. In thyroid carcinogenesis, structural activation of the MAPK signaling pathway plays a fundamental role. Proteins in this pathway consist of receptor tyrosine kinases (RTKs including VEGF, RET, ALK and TRK), RAS, BRAF, MEK and ERK. The MAPK signaling pathway is a pathway associated with cell proliferation, differentiation and survival that plays a role in the development of different thyroid carcinoma subtypes.

Anahtar Kelimeler

• Thyroid carcinogenesis
• MAPK signaling pathway
• prognostic marker

Kaynakça

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