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甲状腺癌灶或转移灶具有摄131I能力是131I治疗的基础.DTC因碘代谢相关基因的表达下调或丧失导致细胞对131I的摄取能力减弱,发展为131I难治性DTC,至今仍缺乏有效治疗手段,预后很差.再分化机制的研究对131I难治性DTC患者的治疗及预后具有重要意义.该文主要从上调甲状腺碘代谢相关基因表达、抑制表观遗传改变、干预异常激活的信号传导通路3个方面对131I难治性DTC再分化研究进展进行综述.

The effect of 131I therapy for primary and metastatic lesions of thyroid carcinoma depends on the ability of iodine uptake.The loss or down-regulation of iodine-metabolizing genes represents dedifferentiation of DTC,which results in the disability to take up and accumulate 131I and eventually leads to radioiodine-refractory DTC (RR-DTC).The management of RR-DTC is extremely difficult and the prognosis is poor.It is important for the treatment and prognosis of RR-DTC to investigate the mechanism of redifferentiation.The up-regulation of thyroid iodine-metabolizing genes expression,inhibition of the changes in epigenetic modifications and intervention of the abnormal activation of signaling pathways are reviewed in this article.