Молекулярные особенности рака щитовидной железы у детей

Обоснование. Злокачественные новообразования щитовидной железы являются наиболее распространенными эндокринными злокачественными новообразованиями в детской возрастной группе. В отличие от взрослых, у которых чаще всего  встречаются  мутации  BRAF  и  RAS,  у  детей  наблюдаются  хромосомные  перестройки.  Актуальность  объясняется отсутствием всесторонних исследований, посвященных раку щитовидной железы у детей, в русскоязычной литературе.

Цель  исследования  —  обобщить  и  систематизировать  литературные  данные,  посвященные  молекулярным  особенностям рака щитовидной железы у детей.

Материалы и методы. Авторами был проведен поиск публикаций в электронной базе данных PubMed с использованием следующего алгоритма: Molecular AND Thyroid cancer AND pediatrics. Нами была обнаружена  451  публикация,  после  просмотра  аннотаций  в  обзор  было  включено  111  исследований,  описывающих молекулярные особенности рака щитовидной железы в педиатрической популяции. Публикации исключались по причине дублирования и несоответствия тематике настоящего исследования.

Результаты. Вместо точечных мутаций BRAF и RAS, характерных для взрослых, независимо от радиационного статуса, у детей чаще встречаются хромосомные перестройки. Реаранжировка генов RET/PTC является наиболее распространенной, за ней следуют слияния BRAF. Мутации промотора TERT, которые являются маркерами агрессивного течения заболевания у взрослых, у детей встречаются редко. Мутации DICER1, по-видимому, играют ключевую роль в педиатрических случаях фолликулярного и папиллярного рака щитовидной железы. Медуллярный рак щитовидной железы (МРЩЖ) у детей требует исключения синдрома множественных эндокринных неоплазий (МЭН 2-го типа). Опухоли, происходящие из фолликулярных клеток, отличные от МРЩЖ, редко могут быть семейными. Литературные данные о роли микроРНК в качестве биомаркера при карциномах щитовидной железы у детей на сегодняшний день ограниченны.

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