THE CLINICAL AND PROGNOSTIC SIGNIFICANCE OF TERT GENE PROMOTER MUTATIONS IN THYROID CANCER IN YOUNG ADULT PATIENTS: A LITERATURE REVIEW

M.A. Mussulmanova, L. Pak, Aidana M. Rakhmankulova, Nailya Kabildina, Tolegen S. Kurmangaliyev

2026

Full text Open access: Hybrid Metadata (CSL-JSON)
DOI 10.52532/3135-3940-2026-3-792
Data confidence 70 medium
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Abstract

Relevance: Although thyroid cancer in young adults usually has a favorable prognosis, some patients experience aggressive disease progression, recurrence, metastasis, and radioiodine resistance. In recent years, research attention has focused on molecular prognostic markers, with telomerase reverse transcriptase (TERT) promoter mutations playing an important role. Despite their relatively low prevalence among young adults, these mutations may indicate an unfavorable clinical course.The study aimed to analyze the current literature on the clinical and prognostic significance of TERT promoter mutations in young adults with thyroid cancer.Materials and Methods: The authors conducted a literature search using keywords related to thyroid cancer, TERT promoter mutations, young adults, prognosis, recurrence, metastasis, and radioiodine resistance in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. The review primarily included original studies, review articles, systematic reviews, and meta-analyses published between 2016 and 2026. Exclusion criteria were the lack of full text, duplicate publications, conference abstracts, and articles lacking clinical or prognostic data. The authors identified 120 publications and included 40 in the final analysis.Results: The literature review showed that TERT promoter mutations are associated with more aggressive clinical and pathological characteristics of thyroid cancer, including larger tumor size, advanced disease stage, lymphatic and distant metastases, recurrence, and reduced survival. The BRAF V600E/TERT co-mutation may be associated with particularly adverse outcomes and has potential prognostic significance.Conclusion: Despite their low prevalence in this age group, TERT promoter mutations may have prognostic relevance in differentiated thyroid cancer among young adults; however, further age-specific studies are needed to confirm their clinical utility.