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Diagnosis of thyroid nodules
The Lancet Diabetes & Endocrinology ( IF 44.0 ) Pub Date : 2022-06-22 , DOI: 10.1016/s2213-8587(22)00101-2
Erik K Alexander 1 , Edmund S Cibas 2
Affiliation  

Thyroid nodules are common, usually asymptomatic, and often pose minimal risk to the affected patient. However, 10–15% prove malignant and serve as the rationale for diagnostic assessment. Safely identifying and treating a relevant thyroid cancer through a cost-effective process is the primary goal of the treating practitioner. Ultrasound is the principal means of initial nodule assessment and should be performed when any thyroid nodule is suspected. Fine-needle aspiration provides further cytological determination of benign or malignant disease and is generally applied to nodules larger than 1–2 cm in diameter, on the basis of holistic risk assessment. The Bethesda System for Reporting Thyroid Cytopathology provides standardised terminology, which enhances communication among health-care providers and patients. Benign cytology is highly accurate, whereas indeterminate cytology could benefit from further application of molecular testing. The ultimate goal of diagnostic assessment of thyroid nodules is to accurately identify malignancy while avoiding overtreatment. Low-risk thyroid nodules can be safely monitored in many patients with minimal diagnostic intervention.



中文翻译:

甲状腺结节的诊断

甲状腺结节很常见,通常无症状,并且通常对受影响的患者构成的风险很小。然而,10-15% 证明是恶性的并作为诊断评估的依据。通过具有成本效益的过程安全地识别和治疗相关的甲状腺癌是治疗从业者的主要目标。超声是初步结节评估的主要手段,当怀疑有任何甲状腺结节时应进行超声检查。在整体风险评估的基础上,细针穿刺可进一步确定良性或恶性疾病的细胞学特征,通常适用于直径大于 1-2 cm 的结节。用于报告甲状腺细胞病理学的 Bethesda 系统提供标准化的术语,增强医疗保健提供者和患者之间的沟通。良性细胞学是高度准确的,而不确定的细胞学可以受益于分子检测的进一步应用。甲状腺结节诊断评估的最终目标是准确识别恶性肿瘤,同时避免过度治疗。许多患者只需极少的诊断干预即可安全监测低风险甲状腺结节。

更新日期:2022-06-23
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