在不确定的甲状腺结节中进行分子测试:为临床决策提供了额外的工具
Caterina Fumagalli1, Giovanni Serio1
1Division of Pathology, ASST Valle Olona, Busto Arsizio (VA).
Pathologica
|September 15, 2023
概括
对未确定的甲状腺结节 (ITN) 的分子检测可以提高诊断准确度. 本综述涉及分子面板在临床决策中的作用,其有效性和成本挑战.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 分子诊断学 分子诊断
背景情况:
- 甲状腺结节很常见,5-15%是恶性的.
- 精细针吸收 (FNA) 在20-30%的病例中产生不确定的甲状腺结节 (ITN) 诊断.
- 由于可变的恶性瘤风险 (5-40%) 和过度治疗风险,管理ITN具有挑战性.
研究的目的:
- 审查分子测试在管理不确定的甲状腺结节中的作用.
- 解决有关分子面板临床实用性和影响的关键问题.
主要方法:
- 关于甲状腺结节分子检测的当前文献的综述.
- 分子面板性能分析 (特异性,灵敏性,预测值).
主要成果:
- 分子测试可以增强良性和恶性结节之间的区别.
- 突出的问题包括面板的实用性作为"规则"/"排除"工具和临床决策的影响.
结论:
- 分子测试为改善ITN风险分层提供了潜力.
- 需要对临床整合,成本效益和报销进行进一步评估.
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