Thyroid Cancer

Diagram - Thyroid Cancer

Specific aims:

  • Characterize the molecular epidemiology important in the development of thyroid cancer.
  • Identify the molecular genetic aberrations contributing to the development of various forms of thyroid cancer. In particular, identify prognostic markers leading to more aggressive forms of thyroid cancer such as the tall cell variant, columnar cell variant, diffuse sclerosing variant, insular carcinoma and Hürthle cell carcinomas.
  • Development of molecular markers distinguishing thyroid follicular adenoma and carcinoma based on cytological samples.
  • Clinical and genetic characterization of familial non-medullary thyroid cancer.

Thyroid cancer is the fastest-growing type of cancer in American women. A number of different variants exist and can be classified based on differentiation.

Classification of thyroid carcinoma based on differentiation.

  • Well differentiated (low grade malignancy)
    • Usual papillary thyroid carcinoma (PTC)
    • Usual follicular thyroid carcinoma (FTC)
    • Variants of papillary carcinoma
      • Encapsulated
      • Cystic
      • Microcarcinoma
  • Intermediate differentiation
    • Tall cell variant of papillary carcinoma (TCV)
    • Columnar cell variant of papillary carcinoma (CCV)
    • Diffuse sclerosing variant of papillary carcinoma (DSV)
    • Insular carcinoma (IC)
    • Hürthle cell (oxyphilic; oncocytic) carcinomas (HCC)
    • Medullary thyroid carcinoma (MTC)
  • Poorly differentiated (high grade malignancy)
    • Anaplastic (undifferentiated) carcinoma

More recently, the role of genetic predisposition to thyroid cancer has been appreciated also for well differentiated thyroid cancer. Various polymorphisms in the Fas/Fas ligand gene and the HLA genes have been linked to an increased risk, and possibly, aggressiveness of papillary thyroid cancer.

Additionally, the molecular genetics of non-medullary thyroid cancer is starting to be unveiled.

Variants of familial non-medullary thyroid cancer.

Despite recent advances in the understanding of the pathophysiology and molecular genetics of thyroid cancer, a number of important scientific questions remain.