Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed as “carcinoma” in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and <30%, >5 and <10%, and ≤5%. Indolent thyroid tumors with an excellent prognosis have the following four features: young age, early-stage (T1-2 M0), curatively treated, and low proliferation index (Ki-67 labeling index of ≤5%), and are unlikely to recur, metastasize, or cause cancer death. Accurate identification of these indolent tumors helps clinicians select more conservative treatments to avoid unnecessary aggressive (total thyroidectomy followed by radio-active iodine) treatments. Clinicians can alleviate the fears of patients by confirming these four features, including the low proliferation rate, in a pathology report immediately after surgery when patients are most concerned.

目前的组织病理学诊断方法无法区分两种类型的甲状腺癌：具有潜在复发、转移和癌症死亡风险的临床显着癌，以及生长速度缓慢的临床不显着癌。在当前的病理学实践中，这两种甲状腺肿瘤都被诊断为“癌”。临床医生通常会向患者推荐手术，而患者通常会因为癌症术语而接受手术。这些临床上无关紧要的癌症的治疗不会使患者受益，并对社会产生负面影响。作者提出使用生长率（Ki-67 标记指数）对甲状腺肿瘤进行风险分层，根据 Ki-67 标记指数准确区分四个与预后相关的风险组，≥30%、≥10 和 <30%、>5 <10%，且≤5%。具有良好预后的惰性甲状腺肿瘤具有以下四个特征：年轻、早期（T1-2 M0）、治愈性治疗、低增殖指数（Ki-67标记指数≤5%），并且不太可能复发、转移或导致癌症死亡。准确识别这些惰性肿瘤有助于临床医生选择更保守的治疗方法，以避免不必要的侵略性（甲状腺全切除术，然后是放射性碘）治疗。临床医生可以通过在患者最关心的手术后立即在病理报告中确认包括低增殖率在内的这四个特征来减轻患者的恐惧。并且不太可能复发、转移或导致癌症死亡。准确识别这些惰性肿瘤有助于临床医生选择更保守的治疗方法，以避免不必要的侵略性（甲状腺全切除术，然后是放射性碘）治疗。临床医生可以通过在患者最关心的手术后立即在病理报告中确认包括低增殖率在内的这四个特征来减轻患者的恐惧。并且不太可能复发、转移或导致癌症死亡。准确识别这些惰性肿瘤有助于临床医生选择更保守的治疗方法，以避免不必要的侵略性（甲状腺全切除术，然后是放射性碘）治疗。临床医生可以通过在患者最关心的手术后立即在病理报告中确认包括低增殖率在内的这四个特征来减轻患者的恐惧。