精确病理诊断在甲状腺癌精准医疗中的意义

甲状腺癌是近年来发病率上升最快的实体恶性肿瘤，其中绝大多数为滤泡细胞来源，以分化型甲状腺癌为主，包括甲状腺乳头状癌（papillary thyroid cancer，PTC）和滤泡癌（follicular thyroid cancer，FTC）。为实现甲状腺癌的精准预防、诊断和治疗，需要以精确病理诊断作为基础。本文分别从评估并降低甲状腺癌发生风险、术前精确诊断、预后和复发风险分层，以及指导晚期患者分子靶向治疗等方面来阐述精确病理诊断在甲状腺癌精准医疗中的意义。 

Accurate pathological diagnosis of thyroid cancer in the era of precision medicine

Thyroid cancer is the malignant tumor with the most rapidly increasing incidence in recent years, the overwhelming majori-ty of which are derived from follicular cells. The most common tumor entity is differentiated thyroid cancer, which could be divided in-to papillary thyroid cancer and follicular thyroid cancer. The accurate pathological diagnosis of thyroid cancer is the cornerstone in the process of precision medicine which includes prevention, diagnosis and treatment. This review discusses the significance of accurate pathological diagnosis in the precision medicine of thyroid cancer based on the following four aspects:1) the risk evaluation of thyroid cancer, 2) preoperative accurate diagnosis of thyroid nodules, 3) the risk stratification of prognosis and recurrence, and 4) the guid-ance of molecular targeted therapy in advanced patients.