The Angiogenic Microenvironment of Thyroid Cancer: An Insight into the Research of New Prognostic Markers

Thyroid cancer is the most common endocrine malignancy, with an overall good prognosis, despite an increasing incidence and a notable recurrence and metastases rate. A portion of thyroid cancers progresses to aggressive and refractory disease. Unfortunately, no test is available to accurately differentiate before surgery patients that requiring total thyroidectomy with or without lymph node removal from those that can be cured with hemithyroidectomy or deserve active surveillance. Understanding how angiogenesis turns into a deregulated process, leading to the angiogenic switch that causes the formation of new vessels, local invasion, proliferation, and metastases, is one of the critical sectors of research in the field of thyroid cancer behavior. Studying several molecular pathways, and characterizing the angiogenic microenvironment of thyroid cancer, allows researchers to identify more than one mediator that can be used as risk stratification markers and targets for new therapies. Therefore, the scientific community aims to dissect the angiogenic microenvironment of thyroid cancer with multi-omic and translational approaches to discover how to predict de-differentiation and radioiodine resistance preoperatively, to limit diagnostic thyroidectomies, as well as to find new molecules to treat advanced cases.