Abstract

Thyroid cancer is one of the most common malignancies, wherein the application of molecular biology is making significant breakthroughs. This comprehensive review summarizes the latest updates on the role of molecular pathology in the diagnosis, treatment, and prognosis of thyroid cancer. Diagnostically, profiling genetic alterations (such as BRAF, RAS, TERT) and utilizing next-generation sequencing (NGS) panels improve diagnostic accuracy, particularly in risk-stratifying thyroid nodules with indeterminate cytology (Bethesda III/IV). Therapeutically, the advent of targeted therapies (e.g., multikinase, BRAF, RET, and TRK inhibitors) and emerging immunotherapies offer promising new approaches for advanced, rapidly progressive, or radioiodine-refractory cases. Furthermore, the application of liquid biopsy and novel biomarkers demonstrates tremendous potential in monitoring minimal residual disease (MRD), detecting early recurrence, and evaluating drug resistance mechanisms. Finally, deciphering the molecular epidemiological characteristics to develop a specific gene panel for the Vietnamese population remains a highly practical direction to optimize personalized medicine strategies.