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RAS-突变细胞学上不确定的甲状腺结节:在积极监测下恶性病发率和行为

Hannah J Sfreddo¹, Elizabeth S Koh¹, Karena Zhao¹

¹Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Thyroid : official journal of the American Thyroid Association

|February 26, 2024

概括

大多数RAS突变性不确定性甲状腺结节 (ITNs) 在主动监测 (AS) 管理下显示稳定性,生长和恶性瘤的发病率较低. 对所有RAS突变ITN的立即手术可能是一个低价值的做法.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
基因组学就是基因组学.

背景情况:

基因组分析有助于确定不确定的甲状腺结节 (ITN) 的风险分层.
在良性和恶性甲状腺结核中存在RAS基因突变.
长期RAS突变ITN的行为尚不清楚,往往导致立即手术.

研究的目的:

描述RAS突变ITN的瘤生长动力学,这些ITN在主动监测 (AS) 管理下进行管理.
为了检查经过手术切除的RAS突变ITN的组织病理学诊断.
评估所有RAS突变ITN立即手术的必要性.

主要方法:

追溯队列研究分析了来自两个队列的超声波 (美国) 和组织病理学数据:AS下的RAS突变ITN和那些经过立即手术管理的ITN.
AS队列:≥3个月的随访,≥2次US扫描;成长定义为≥72%的瘤体积变化.
立即手术队列:病理诊断和长期结果的分析.

主要成果:

在AS队列 (63个结节) 中,平均23个月的增长率为19.0%;81.0%保持稳定.
来自AS队伍的6个手术切除的结节中,只有1个是恶性.
在即时手术队列中 (209个结节),33%是恶性,大多数是低风险的.

结论:

在主动监测下管理的RAS突变ITN在长时间内表现出主要稳定的瘤行为.
对所有RAS突变ITN的立即外科切除似乎是一个低价值的做法.
需要进一步的研究,以指导选择RAS突变ITN的积极监测与立即手术.

关键词:

这是一种RAS基因突变.甲状腺Seqq 甲状腺积极监督是指积极的监督.细胞学上不确定的甲状腺结节.甲状腺结节甲状腺结节

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