Stratification of well-differentiated thyroid cancer based on molecular genetic testing: A literature review

Abstract

Relevance: Thyroid cancer (TC) is among the most significant malignant diseases of the head and neck, with a steadily growing number of newly diagnosed cases throughout the world. Despite a relatively modest 17th place of TC in the structure of cancer incidence, its treatment in recent decades has seriously worried scientists and physicians due to a very rapid increase in TC incidence among young and middle-aged people. Iodine deficiency decreases immune function, and the effects of ionizing radiation play a role in the development of thyroid cancer. This leads to the development of a stratification system for well-differentiated thyroid cancer (WDTC) at the molecular genetic level. This system is necessary to select patients at risk of progression and to apply aggressive radionuclide therapy and suppressive hormone therapy only to those patients who need it.

The study aimed to systematize data from the current literature to assess the need to develop a prognostic stratification of patients with WDTC based on molecular genetic testing.

Methods: A literature review of scientific publications was conducted from the PubMed search database from September 2017 to December 2023. Inclusion criteria: publication date from 2017 to present for the main keywords: ‘High differentiated thyroid cancer”, “prognostic stratification of WDTC based on molecular tests, ‘WDTC mutation markers.’ Some clinical studies of domestic and foreign specialists were also considered.

Results: Based on a meta-review of literature data on prognostic stratification of WDTC patients, the rationale for expanding the panel of genetic markers associated with aggressive forms of WDTC is presented, the importance of gene mutation in the occurrence of disease recurrence, and the choice of adequate treatment is proven.

Conclusion: Research efforts are underway to find genetic and pathomorphologic predictors of the prognosis of the disease. Knowledge of molecular and genetic mechanisms of tumorigenesis provides a wide range of opportunities for applying molecular diagnostics in differential diagnosis, prognosis of the course of the disease, and treatment of aggressive forms of tumors.