In 1989, Stephen Paget proposed the ‘seed and soil’ theory of cancer metastasis. This theory has led to previous researchers focusing on the role of a tumour as a cancer seed and antiangiogenesis agents as cancer soil fumigant; for the latter to be effective, it is important for them to be able to distinguish cancer cells from stromal cells. However, antiangiogenesis agents have not produced dramatic survival benefits in vivo. This may be related to their inability to destroy the supporting stroma that promote cancer cell growth. Therefore, in order to effectively arrest cancer cell growth for therapeutic purposes, a paradigm shift is required in our fundamental approach to decipher the molecular events and networks in the stromal environment that cancer cells can thrive and proliferate. The pathogenesis of cancer is a multidimensional process of pathological molecular and cellular pathways, influencing different stromal properties and achieving a mutually negotiated crosstalk between cancer cells and stromal cells. This review summarises the clinical presentation of current knowledge of classical papillary thyroid carcinoma (PTC), emerging molecular diagnostics and future directions of classical PTC research.
- molecular pathology
- thyroid neoplasms
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Handling editor Runjan Chetty.
Contributors JH performed the literature review and was responsible for writing the review paper. JWP reviewed grammar and corrected the manuscript. BW and AS provided advisory input for this manuscript. NN provided expert opinion in the context of endocrine cancer. CSL coordinated the above and consulted for cancer pathology.
Funding This study was supported by the School of Medicine, Western Sydney University, Liverpool, NSW, Australia.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.