- Modern Pathology 综述（Justine A. Barletta、Raja R. Seethala，2026-10-23 在线），USCAP 2026-11-01 在 X 上推送。以问答形式讨论病理医生评估这两类侵袭性甲状腺癌的基本概念和实际问题。
- 分类：高级别滤泡细胞起源的非间变性甲状腺癌目前分为低分化甲状腺癌和较新的高级别分化型甲状腺癌，后者最常见的亚型是高级别乳头状甲状腺癌；在分子和临床上介于分化型甲状腺癌与间变性甲状腺癌（ATC）之间。
- ATC 诊断难点：需排除的鉴别诊断很多，且常只有有限的组织取材。
- 报告落地：在靶向治疗和免疫检查点抑制剂时代，ATC 的生物标志物检测已至关重要。原文为 Elsevier 订阅内容，本站仅收摘要。
收录范围：PubMed 摘要中英对照。原文为 Elsevier 订阅内容，本站未获全文与图表。
摘要
高级别滤泡细胞起源的非间变性甲状腺癌与间变性甲状腺癌（ATC）虽不常见，却代表甲状腺癌谱系中侵袭性最强、致死比例最高的一端，因此准确识别尤为重要。高级别滤泡细胞起源甲状腺癌在分子和临床层面都架起了分化型甲状腺癌与 ATC 之间的桥梁。这一肿瘤家族的概念已有显著演变，目前细分为低分化甲状腺癌和较新认识的高级别分化型甲状腺癌，后者最常见的亚型是高级别乳头状甲状腺癌。ATC 则是典型的侵袭性甲状腺癌，被认识已超过一个半世纪。然而，ATC 仍可能带来相当大的诊断难度：在作出 ATC 诊断之前，需要考虑的鉴别诊断范围很广，涉及许多病种；而且诊断常因组织取材有限而更加复杂。在靶向治疗和免疫检查点抑制剂治疗的当下，ATC 的生物标志物检测已至关重要。本综述以问答形式，讨论病理医生评估这些侵袭性肿瘤类型时遇到的基本概念和实际问题。
- Modern Pathology review by Justine A. Barletta and Raja R. Seethala (online 23 October 2026), shared by USCAP on X on 1 November 2026; written as questions and answers on fundamental concepts and pragmatic issues.
- Classification: high-grade follicular cell-derived non-anaplastic thyroid carcinoma is now subdivided into poorly differentiated thyroid carcinoma and high-grade differentiated thyroid carcinoma (most commonly high-grade papillary thyroid carcinoma), bridging well differentiated carcinoma and anaplastic thyroid carcinoma (ATC).
- ATC pitfalls: a broad differential diagnosis and often limited tissue sampling.
- Reporting: biomarker testing for ATC is critical in the era of targeted and checkpoint inhibitor therapy. Elsevier subscription content — abstract only.
Scope: the PubMed abstract. The article is Elsevier subscription content; the full text and figures were not obtained.
Abstract
Although uncommon, high-grade follicular cell-derived non-anaplastic thyroid carcinoma and anaplastic thyroid carcinoma (ATC) represent the most aggressive and disproportionately lethal end of the thyroid cancer spectrum, making accurate recognition particularly important. High-grade follicular cell-derived thyroid carcinoma bridges the gap both from a molecular and clinical perspective between well differentiated thyroid carcinomas and ATC. This family of tumors has significantly evolved and is currently subdivided into poorly differentiated thyroid carcinoma and the more recently recognized high-grade differentiated thyroid carcinoma, of which high-grade papillary thyroid carcinoma is the most common subtype. ATC, on the other hand, is the prototypical aggressive thyroid cancer type that has been recognized for over a century and a half. However, ATC can still pose a significant diagnostic challenge because of the broad differential diagnosis with many entities that need to be considered before rendering an ATC diagnosis. Moreover, the diagnosis is often further complicated by limited tissue sampling. Biomarker testing for ATC is now of critical importance in the modern era of targeted therapy and checkpoint inhibitor therapy. This review addresses fundamental concepts and pragmatic issues that pathologists encounter when evaluating these aggressive tumor types in a narrative question-and-answer format.