Atualizações em marcadores relacionados ao câncer de tireoide e associação com o prognóstico e diagnóstico

Abstract

Introduction: Thyroid cancer is the most common endocrine neoplasm among head and neck tumors. With its increasing incidence, it becomes essential to seek effective therapeutic strategies. Biomarkers have shown promise in prognostic evaluation and in guiding clinical management, yet there remains a paucity of conclusive studies, underscoring the need for further research. Objectives: To identify biomarkers associated with the prognosis of patients with thyroid cancer. Methodology: A literature review was conducted on PubMed using the search terms “thyroid cancer AND biomarkers,” applying filters for the last five years, clinical study, clinical trial, meta-analysis, English, and humans. Out of the 68 articles found, 28 were selected based on the titles and 11 after reading the abstracts. The selection was conducted by two independent reviewers. Results: Many biomarkers have been studied, primarily in papillary carcinoma, aiming to improve diagnosis, risk stratification, and treatment response. In radioiodine-refractory differentiated thyroid cancer (RR-DTC), low serum levels of Angiopoietin-2 (Ang-2) and sTie2 indicate a good prognosis. Elevated levels of IGF-1 were associated with advanced disease. PD-L1 expression, particularly in conjunction with the BRAF V600E and TERT mutations, is associated with worse prognosis. Other relevant markers include the PAX8-PPARG fusion, mutations in RAS, RET, SLX4, ATM, NRAS, THADA, as well as SESN2 gene deletion and low expression of TFF3. Conclusion: The combination of biomarkers has demonstrated good accuracy in predictive models, especially when paired with imaging studies. However, methodological limitations necessitate further studies before their routine clinical application.