未分化及失分化甲状腺癌治疗进展.pdfVIP

2009年第36卷第10期 中国肿瘤临床 ·597· · · 综 述 未分化及失分化甲状腺癌治疗进展 陈泽泉 综述 罗全勇 余永利 审校 上海交通大学附属上海第六人民医院核医学科 （上海市 200233） 摘要 未分化及失分化甲状腺癌是死亡率较高的内分泌恶性肿瘤，目前尚缺乏有效的治疗手段，寻找新的治 疗手段显得尤为迫切。一系列新的治疗方法的出现为未分化及失分化甲状腺癌患者的治疗提供了可能：基因治 疗，如通过恢复抑癌基因功能的基因治疗（恢复P53基因功能）或自杀基因导入治疗，抗肿瘤血管形成的基因治疗， 钠/碘转运蛋白（NIS）基因介导的放射性碘治疗；诱导分化治疗如：通过维甲酸及组蛋白乙酰化酶抑制剂诱导分化治 疗可促进肿瘤细胞的分化，有助于控制肿瘤的发展，而金属蛋白酶抑制剂的应用可控制肿瘤细胞的转移。而手术 方式、放化疗方案的改进及综合应用亦可延长甲状腺未分化及失分化癌患者的生存时间。本文就上述新的甲状腺 癌的治疗方案做一综述。 关键词 未分化甲状腺癌 失分化甲状腺癌 基因治疗 诱导分化治疗 doi:10.3969/j.issn.1000-8179.2009.10.016 ProgressintheTreatmentofAnaplasticandDedifferentiatedThyroidCancer CHEN Zequan, LUO Quanyong, YU Yongli Corresponding author: YU Yongli, E-mail: yuyongli56@ Department of Nuclear Medicine, The Sixth Peoples Hospital, Shanghai Jiaotong University, Shanghai 200233; China Abstract Anaplastic and dedifferentiated thyroid carcinomas are typically lethal malignancies that occur in the endocrine system that currently do not have any effective therapy. Development and evaluation of novel treatment strategies for these types of carcinoma are urgently needed. A variety of new therapies for anaplas- tic and dedifferentiated thyroid cancer has been evaluated, including corrective gene therapy (p53 restora- tion), cytoreductive gene therapy (suicide gene/prodrug strategy herpes simplex virus-thymidine kinase [HSV-tk]/ganciclovir), antiangiogenic gene therapy, and immunomodulatory gene therapy (expression of inter- leukin (IL)-2 and IL-12). Cloning of the sodium i