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Kalfert D, Ludvikova M, Pesta M, Hakala T, Dostalova L, Grundmannova H, Windrichova J, Houfkova K, Knizkova T, Ludvik J, Polivka J, Kholova I. BRAF mutation, selected miRNAs and genes expression in primary papillary thyroid carcinomas and local lymph node metastases. Pathol Res Pract 2024; 258:155319. [PMID: 38696857 DOI: 10.1016/j.prp.2024.155319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/04/2024]
Abstract
Mutations in cancer-related genes are now known to be accompanied by epigenetic events in carcinogenesis by modification of the regulatory pathways and expression of genes involved in the pathobiology. Such cancer-related mutations, miRNAs and gene expression may be promising molecular markers of the most common papillary thyroid carcinoma (PTC). However, there are limited data on their relationships. The aim of this study was to analyse the interactions between BRAF mutations, selected microRNAs (miR-21, miR-34a, miR-146b, and miR-9) and the expression of selected genes (LGALS3, NKX2-1, TACSTD2, TPO) involved in the pathogenesis of PTC. The study cohort included 60 primary papillary thyroid carcinomas (PTC) that were classified as classical (PTC/C; n=50) and invasive follicular variant (PTC/F; n=10), and 40 paired lymph node metastases (LNM). BRAF mutation status in primary and recurrent/persistent papillary thyroid carcinomas was determined. The mutation results were compared both between primary and metastatic cancer tissue, and between BRAF mutation status and selected genes and miRNA expression in primary PTC. Furthermore, miRNAs and gene expression were compared between primary PTCs and non-neoplastic tissue, and local lymph node metastatic tumor, respectively. All studied markers showed several significant mutual interactions and contexts. In conclusion, to the best our knowledge, this is the first integrated study of BRAF mutational status, the expression levels of mRNAs of selected genes and miRNAs in primary PTC, and paired LNM.
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Affiliation(s)
- David Kalfert
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marie Ludvikova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic.
| | - Martin Pesta
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Tommi Hakala
- The Wellbeing Services County of Pirkanmaa, Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Lucie Dostalova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Grundmannova
- Laboratory of Immunoanalysis, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Jindra Windrichova
- Laboratory of Immunoanalysis, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Katerina Houfkova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Tereza Knizkova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Jaroslav Ludvik
- Department of Imaging Methods, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jiri Polivka
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ivana Kholova
- Pathology, Fimlab Laboratories, Tampere, Finland and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
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Toraih EA, Ruiz E, Ning B, Tortelote GG, Hilliard S, Moroz K, Hu T, Fawzy MS, Kandil E. Chromatin-Accessible miRNA Regulons Driving Thyroid Tumorigenesis and Progression. J Am Coll Surg 2023; 236:732-750. [PMID: 36728308 DOI: 10.1097/xcs.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although papillary thyroid cancer can remain indolent, associated lymph node metastases and recurrence rates are approximately 50% and 20%, respectively. Omics-based medicine has led to the discovery of predictive biomarkers that can be used to predict tumor progression and clinical outcomes. We aimed to develop a noninvasive omics-driven blood test to allow accurate risk stratification and help tailor individual patient treatment plans. STUDY DESIGN RNA sequencing (seq) and microRNA analysis of The Cancer Genome Atlas and Gene Expression Omnibus datasets were employed to identify an epigenetic prognostic panel. Integrated bulk assay for transposase-accessible chromatin-seq and RNA-seq experiments confirmed the results. Sixty-two paired tumor and adjacent control thyroid tissues and 67 blood samples (62 papillary thyroid cancer and 5 controls) were analyzed for validation using sequencing and real-time polymerase chain reaction and correlated to clinical outcomes. A liposome-exosome fusion clustered regularly interspaced short palindromic repeats (CRISPR)-fluorescent detection system miRNA assay was developed. A predictive risk nomogram was generated and tested for performance. RESULTS Our miRNA panel (miR-146b-5p and miR-221-3p) from tissue and blood was associated with aggressive features and was located within accessible chromatin regions. The miRNA risk score and prognostic nomogram showed higher accuracy in predicting lymph node metastases (miR-146b: area under the curve [AUC] 0.816, sensitivity 76.9%; miR-221: AUC 0.740, sensitivity 79.5%) and recurrence (miR-146b: AUC 0.921, sensitivity 75.0%; miR-221: AUC 0.756, sensitivity 70.0%; p < 0.001) than staging and American Thyroid Association risk stratification. CRISPR-based miRNA assays showed upregulation in the blood of cancer cohorts. CONCLUSIONS CRISPR-based detection of miR-146b and miR-221 in the blood of thyroid cancer patients is a reliable and noninvasive tool for real-time assessment and prognostication that has great potential to provide a direct impact on the care of these patients.
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Affiliation(s)
- Eman A Toraih
- From the Division of General Endocrine and Oncologic Surgery, Department of Surgery (Toraih, Kandil), Tulane University School of Medicine, New Orleans, LA
- the Medical Genetics Unit, Department of Histology and Cell Biology (Toraih); Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, and Suez Canal University, Ismailia, Egypt
| | - Emmanuelle Ruiz
- the Department of Pathobiological Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA (Ruiz)
| | - Bo Ning
- Department of Biochemistry and Molecular Biology (Ning, Hu), Tulane University School of Medicine, New Orleans, LA
| | - Giovane G Tortelote
- Section of Pediatric Nephrology, Department of Pediatrics (Tortelote, Hilliard), Tulane University School of Medicine, New Orleans, LA
| | - Sylvia Hilliard
- Section of Pediatric Nephrology, Department of Pediatrics (Tortelote, Hilliard), Tulane University School of Medicine, New Orleans, LA
| | - Krzysztof Moroz
- Department of Pathology and Laboratory Medicine (Moroz), Tulane University School of Medicine, New Orleans, LA
| | - Tony Hu
- Department of Biochemistry and Molecular Biology (Ning, Hu), Tulane University School of Medicine, New Orleans, LA
| | - Manal S Fawzy
- the Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia (Fawzy)
| | - Emad Kandil
- From the Division of General Endocrine and Oncologic Surgery, Department of Surgery (Toraih, Kandil), Tulane University School of Medicine, New Orleans, LA
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3
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Macerola E, Poma AM, Vignali P, Proietti A, Torregrossa L, Ugolini C, Basolo A, Matrone A, Elisei R, Santini F, Basolo F. MicroRNA expression profiling of RAS-mutant thyroid tumors with follicular architecture: microRNA signatures to discriminate benign from malignant lesions. J Endocrinol Invest 2023:10.1007/s40618-023-02023-5. [PMID: 36749451 DOI: 10.1007/s40618-023-02023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE RAS mutations represent common driver alterations in thyroid cancer. They can be found in benign, low-risk and malignant thyroid tumors with follicular architecture, which are often diagnosed as indeterminate nodules on preoperative cytology. Therefore, the detection of RAS mutations in preoperative setting has a suboptimal predictive value for malignancy. In this study, we investigated differentially expressed microRNA (miRNA) in benign and malignant thyroid tumors with follicular architecture carrying mutations in RAS genes. METHODS Total RNA was purified from 60 RAS-mutant follicular-patterned thyroid tumors, including follicular adenoma (FA), noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), papillary and follicular thyroid carcinoma cases (PTC, FTC); 22 RAS-negative FAs were used as controls. The expression analysis of 798 miRNAs was performed by digital counting (nCounter nanoString platform). RESULTS Comparing RAS-mutant and RAS-negative FAs, 12 miRNAs showed significant deregulation, which was likely related to the oncogenic effects of RAS mutations. Twenty-two miRNAs were differentially expressed in RAS-mutant benign versus malignant tumors. Considering the tumor type, 24 miRNAs were deregulated in PTC, 19 in NIFTP, and seven in FTC and compared to FA group; among these, miR-146b-5p, miR-144-3p, and miR-451a showed consistent deregulation in all the comparisons with the highest fold change. CONCLUSIONS The miRNA expression analysis of follicular-patterned thyroid tumors demonstrated that RAS mutations influences miRNA profile in benign tumors. In addition, several miRNAs showed a histotype-specific deregulation and could discriminate between RAS-mutant benign and RAS-mutant malignant thyroid lesions, thus deserving further investigation as potential diagnostic markers.
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Affiliation(s)
- E Macerola
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - A M Poma
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - P Vignali
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - A Proietti
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - L Torregrossa
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - C Ugolini
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - A Basolo
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - A Matrone
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - R Elisei
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - F Santini
- Department of Clinical and Experimental Medicine, University of Pisa, via Savi, 10, 56126, Pisa, Italy
| | - F Basolo
- Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, via Savi, 10, 56126, Pisa, Italy.
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Maggisano V, Capriglione F, Verrienti A, Celano M, Gagliardi A, Bulotta S, Sponziello M, Mio C, Pecce V, Durante C, Damante G, Russo D. Identification of Exosomal microRNAs and Their Targets in Papillary Thyroid Cancer Cells. Biomedicines 2022; 10:biomedicines10050961. [PMID: 35625697 PMCID: PMC9138952 DOI: 10.3390/biomedicines10050961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 11/16/2022] Open
Abstract
The release of molecules in exosomal cargoes is involved in tumor development and progression. We compared the profiles of exosomal microRNAs released by two thyroid cancer cell lines (TPC-1 and K1) with that of non-tumorigenic thyroid cells (Nthy-ori-3-1), and we explored the network of miRNA–target interaction. After extraction and characterization of exosomes, expression levels of microRNAs were investigated using custom TaqMan Advanced array cards, and compared with those expressed in the total cell extracts. The functional enrichment and network-based analysis of the miRNAs’ targets was also performed. Five microRNAs (miR-21-5p, miR-31-5p, miR-221-3p, miR-222-3p, and let-7i-3p) were significantly deregulated in the exosomes of tumor cells vs. non-tumorigenic cells, and three of them (miR-31-5p, miR-222-3p, and let-7i-3p) in the more aggressive K1 compared to TPC-1 cells. The network analysis of the five miRNAs identified some genes as targets of more than one miRNAs. These findings permitted the identification of exosomal microRNAs secreted by aggressive PTC cells, and indicated that their main targets are regulators of the tumor microenvironment. A deeper analysis of the functional role of the targets of exosomal miRNAs will provide further information on novel targets of molecular treatments for these neoplasms.
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Affiliation(s)
- Valentina Maggisano
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
| | - Francesca Capriglione
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (A.V.); (M.S.); (V.P.); (C.D.)
| | - Marilena Celano
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
| | - Agnese Gagliardi
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
| | - Stefania Bulotta
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (A.V.); (M.S.); (V.P.); (C.D.)
| | - Catia Mio
- Institute of Medical Genetics, Academic Hospital of Udine, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy; (C.M.); (G.D.)
| | - Valeria Pecce
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (A.V.); (M.S.); (V.P.); (C.D.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, “Sapienza” University of Rome, 00161 Rome, Italy; (A.V.); (M.S.); (V.P.); (C.D.)
| | - Giuseppe Damante
- Institute of Medical Genetics, Academic Hospital of Udine, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy; (C.M.); (G.D.)
| | - Diego Russo
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.M.); (F.C.); (M.C.); (A.G.); (S.B.)
- Correspondence: ; Tel.: +39-096-136-94-124
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5
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Galuppini F, Censi S, Merante Boschin I, Fassan M, Sbaraglia M, Valeri N, Hahne JC, Bertazza L, Munari G, Galasso M, Cascione L, Barollo S, Rugge M, Vianello F, Dei Tos AP, Mian C, Pennelli G. Papillary Thyroid Carcinoma: Molecular Distinction by MicroRNA Profiling. Front Endocrinol (Lausanne) 2022; 13:834075. [PMID: 35282462 PMCID: PMC8904882 DOI: 10.3389/fendo.2022.834075] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/26/2022] [Indexed: 12/15/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is a miscellaneous disease with a variety of histological variants, each with its own mutational profile, and clinical and prognostic characteristics. Identification of microRNA (miRNA) expression profiles represents an important benchmark for understanding the molecular mechanisms underlying the biological behavior of these unique PTC subtypes in order that they be better characterized. We considered a series of 35 PTC samples with a histological diagnosis of either hobnail (17 cases) or classical variant (nine cases) and with a specific BRAF p.K601E mutation (nine cases). We determined the overall miRNA expression profile with NanoString technology, and both quantitative reverse transcription-PCR and in situ hybridization were used to confirm selected miRNAs. The miRNA signature was found to consistently differentiate specific histotypes and mutational profiles. In contrast to the BRAF p.K601E mutation and classic PTCs, three miRNAs (miR-21-5p, miR-146b-5p, and miR-205-5p) were substantially overexpressed in the hobnail variant. The current study found that different miRNA signature profiles were linked to unique histological variants and BRAF mutations in PTC. Further studies focusing on the downstream pathogenetic functions of mRNAs in thyroid neoplasms are warranted.
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Affiliation(s)
- Francesca Galuppini
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Simona Censi
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | | | - Matteo Fassan
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
- Veneto Institute of Oncology, Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Marta Sbaraglia
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Nicola Valeri
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Jens Claus Hahne
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Loris Bertazza
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Giada Munari
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Marco Galasso
- Laboratorio per le Tecnologie delle Terapie Avanzate (LTTA), Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luciano Cascione
- Bioinformatics Core Unit, Institute of Oncology Research, Bellinzona, Switzerland
| | - Susi Barollo
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Massimo Rugge
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Federica Vianello
- Department of Radiotherapy, Veneto Institute of Oncology, Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS), Padua, Italy
| | - Angelo Paolo Dei Tos
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Caterina Mian
- Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
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MiR-181a-5p Regulates NIS Expression in Papillary Thyroid Carcinoma. Int J Mol Sci 2021; 22:ijms22116067. [PMID: 34199867 PMCID: PMC8200107 DOI: 10.3390/ijms22116067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/16/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
NIS is a potent iodide transporter encoded by the SLC5A5 gene. Its expression is reduced in papillary thyroid carcinoma (PTC). In this study we analyzed the impact of miR-181a-5p on NIS expression in the context of PTC. We used real-time PCR to analyze the expression of SLC5A5 and miR-181a-5p in 49 PTC/normal tissue pairs. Luciferase assays and mutagenesis were performed to confirm direct binding of miR-181a-5p to the 3′UTR of SLC5A5 and identify the binding site. The impact of modulation of miR-181a-5p using appropriate plasmids on endogenous NIS and radioactive iodine accumulation was verified. We confirmed downregulation of SLC5A5 and concomitant upregulation of miR-181a-5p in PTC. Broadly used algorithms did not predict the binding site of miR-181a-5p in 3′UTR of SLC5A5, but we identified and confirmed the binding site through mutagenesis using luciferase assays. In MCF7 and HEK293-flhNIS cell lines, transfection with mir-181a-expressing plasmid decreased endogenous SLC5A5, whereas silencing of miR-181a-5p increased it. We observed similar tendencies in protein expression and radioactive iodine accumulation. This study shows for the first time that miR-181a-5p directly regulates SLC5A5 expression in the context of PTC and may decrease efficacy of radioiodine treatment. Accordingly, miR-181a-5p may serve as an emerging target to enhance the efficacy of radioactive iodine therapy.
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Molecular Genetics of Follicular-Derived Thyroid Cancer. Cancers (Basel) 2021; 13:cancers13051139. [PMID: 33799953 PMCID: PMC7961716 DOI: 10.3390/cancers13051139] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Thyroid tumors that derive from follicular cells are not a homogeneous entity, showing variable morphological appearance and different degrees of differentiation. Molecular markers are useful for both diagnostic purposes and prognostic stratification of patients. In presurgical setting, molecular testing of indeterminate thyroid nodules on aspirates provides useful diagnostic information; the molecular analysis on tumor tissues can also reveal the presence of genetic alterations related to patients’ prognosis. In recent years, the molecular characterization of these tumors has acquired even more importance thanks to the introduction of targeted drugs. This review summarizes the current literature on the molecular landscape of follicular-derived thyroid tumors. Abstract Thyroid cancer is the most common type of endocrine-related malignancy, whose incidence rates have increased dramatically in the last few decades. Neoplasms of follicular origin generally have excellent prognosis, with the exception of less differentiated tumors. Follicular-derived thyroid cancer can manifest as a variety of morphologically distinct entities, characterized by various degrees of differentiation and invasiveness. Histological evaluation is thus crucial for the definition of patients’ prognosis. However, within each histological subtype, tumor behavior can be highly variable, and, in this respect, molecular characterization can provide insightful information to refine the risk stratification of tumors. In addition to the importance of its prognostic role, molecular testing can be used to support the differential diagnosis of thyroid nodules in the absence of marked cyto-morphological aberrations. Finally, with the advent of targeted drugs, the presence of molecular alterations will guide the therapeutic strategies for patients with advanced tumors who do not respond to standard treatment. This review aims to describe the genetic landscape of follicular-derived thyroid tumors also highlighting differences across histological subtypes.
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