甲状腺结节的诊断和治疗:一个综述
Cosimo Durante1, Giorgio Grani1, Livia Lamartina1
1Dipartimento di Medicina Interna e Specialità Mediche, Università di Roma "Sapienza," Roma, Italy.
JAMA
|March 7, 2018
概括
大多数甲状腺结节是良性的,需要监测. 使用超声波和必要时活检和分子检测的个性化,基于风险的方法确保了对甲状腺结节的最佳护理.
科学领域:
- 内分泌学
- 诊断成像
- 癌症学
背景情况:
- 甲状腺结节非常普遍,在多达65%的人群中检测到,通常是通过成像发现的.
- 大多数甲状腺结节是良性的,在临床上无意义,通过监测进行管理.
- 主要目标是发现少量癌症,引起症状或影响甲状腺功能的结节.
研究的目的:
- 概述甲状腺结节的有效诊断和管理策略.
- 强调个性化,基于风险的方法,尽量减少不必要的干预.
- 改善临床上显著的甲状腺癌的鉴定.
主要方法:
- 使用甲状腺功能测试和超声波指导初始结节管理.
- 使用超声波特征 (例如,囊性,海绵状,固体,低声,不规则的边缘,微化) 来确定是否需要进一步测试.
- 精细针吸收活检和分子检测对于特定的病例,特别是不确定的细胞学.
主要成果:
- 良性结节通常在超声波上表现为囊性或海绵状,不需要进一步检测.
- 怀疑的超声波发现需要细胞学评估.
- 基于超声波和细胞学的风险估计决定了治疗和随访方案.
结论:
- 综合超声波,精细针吸收活检和分子检测的诊断策略使得基于风险的甲状腺结节可以个性化管理.
- 这种方法提高了护理质量,同时降低了成本,避免了不必要的测试.
- 大多数甲状腺结节是良性的,可以通过监测和有针对性的诊断程序有效地管理.
相关概念视频
Review and Preview
8.4K
In statistics, several tools are used to interpret the data. Measures of central tendency represent the characteristics of the data, such as mean, median, and mode. Additionally, measures of variance like standard deviation and range are used to find the spread of data from the mean. Relative standing measures the distance between data locations. Commonly used measures of relative standings are percentile, z score, and quartiles.
Percentiles are a type of fractile that partition data into...
Percentiles are a type of fractile that partition data into...
8.4K
Review and Preview
11.6K
Data are individual items of information obtained from a population or sample. Data may be classified as qualitative (categorical), quantitative continuous, or quantitative discrete. Because it is not practical to measure the entire population in a study, researchers use samples to represent the population. A random sample is a representative group from the population chosen by using a method that gives each individual in the population an equal chance of being included in the sample. Random...
11.6K
The Thyroid Gland
7.8K
The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
7.8K
Functions of Thyroid Hormones
5.8K
The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
5.8K
Nursing Diagnosis
4.3K
Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
The nursing diagnosis focuses on evidence-based...
The nursing diagnosis focuses on evidence-based...
4.3K
Synthesis and Regulation of Thyroid Hormones
8.0K
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
8.0K


