{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T21:58:48Z","timestamp":1777327128757,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The diffuse sclerosing variant of papillary thyroid carcinoma (DSV\u2010PTC) is a rare, aggressive subtype with distinct clinicopathological features. This study aimed to characterize its molecular alterations and evaluate their clinical associations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of 51 DSV\u2010PTC cases was conducted. Clinicopathological data were reviewed, and molecular profiling was performed using fluorescent PCR to detect mutations and gene fusions across 12 thyroid cancer\u2010related genes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included eight paediatric cases (15.7%) and 43 adult cases (84.3%) of DSV\u2010PTC. The most common alteration was <jats:italic>BRAF<\/jats:italic> mutation (39.2%), followed by <jats:italic>RET<\/jats:italic> fusions (25.5%; including <jats:italic>CCDC6\u2010RET<\/jats:italic> in 23.5% and <jats:italic>NCOA4\u2010RET<\/jats:italic> in 2.0%), <jats:italic>ETV6\u2010NTRK3<\/jats:italic> fusion (5.9%) and <jats:italic>TERT<\/jats:italic> promoter mutations (2.0%). Compared with <jats:italic>BRAF<\/jats:italic>\u2010mutated tumours, <jats:italic>RET<\/jats:italic> fusion\u2010positive cases showed significantly larger primary tumours (<jats:italic>p<\/jats:italic>\u2009=\u20090.016), larger metastatic nodes (<jats:italic>p<\/jats:italic>\u2009=\u20090.009) and higher T stages (<jats:italic>p<\/jats:italic>\u2009=\u20090.046). Paediatric patients exhibited more aggressive features, such as higher rates of lateral neck metastasis and extrathyroidal extension, but had fewer <jats:italic>BRAF<\/jats:italic> mutations. The overall recurrence rate was 15.7%, with earlier recurrence in <jats:italic>RET<\/jats:italic> fusion cases. One patient with coexisting <jats:italic>ETV6\u2010NTRK3<\/jats:italic> fusion and <jats:italic>TERT<\/jats:italic> mutation progressed to anaplastic thyroid carcinoma and died of disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DSV\u2010PTC demonstrates substantial molecular heterogeneity. <jats:italic>RET<\/jats:italic> fusions are linked to more aggressive behaviour, and paediatric cases often show extensive locoregional spread. Coexisting <jats:italic>NTRK<\/jats:italic> and <jats:italic>TERT<\/jats:italic> alterations may signal high\u2010risk progression, highlighting the value of molecular stratification in management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.70013","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:17:57Z","timestamp":1754903877000},"page":"729-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Exploring the Molecular Features and Clinicopathological Correlations of Diffuse Sclerosing Papillary Thyroid Carcinoma"],"prefix":"10.1111","volume":"103","author":[{"given":"Yanhui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pathology Tianjin Medical University Cancer Institute and Hospital Tianjin China"},{"name":"National Clinical Research Center of Cancer Tianjin China"},{"name":"Key Laboratory of Cancer Prevention and Therapy Tianjin 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