在移植前的人群中管理偶然的甲状腺结节
Patricia G Lu1, Patrick T Hangge1, Amit K Mathur2
1Mayo Clinic Arizona, Department of Surgical Oncology and Endocrine Surgery, Phoenix, Arizona.
The Journal of surgical research
|October 9, 2024
概括
移植候选人的偶然甲状腺结节的管理得到了改进. 活检率下降,患者在准则通过后更早地进行移植.
科学领域:
- 内分泌学 在内分泌学.
- 移植手术 移植手术
- 放射学 放射学是一门学科.
背景情况:
- 通过诊断成像检测到的偶然甲状腺结节的患病率增加.
- 在移植候选人中管理这些结节的数据有限,由于免疫抑制,这是一个高风险群体.
- 对在移植前评估期间偶然发现的甲状腺结节的机构实践的审查.
研究的目的:
- 审查该机构在移植前患者中偶然发现的甲状腺结节的管理.
- 评估采用甲状腺成像报告和数据系统 (TI-RADS) 和扩大专门的移植中心对患者管理的影响.
- 评估瘤结果和治疗时间表.
主要方法:
- 发生甲状腺结节的移植前患者 (2011-2021) 的多站点回顾性审查.
- 收集人口统计数据,结节特征,治疗时间表和瘤结果.
- 2017年之前和之后患者管理的比较.
主要成果:
- 在10,340名移植患者中发现了236个偶然的甲状腺结节.
- 2017年后:活检建议减少 (39%至29%) 和执行活检较少 (45%至33%).
- 2017年后:从成像到活检的时间显著缩短 (14个月到4个月),从成像到移植的时间 (31个月到11个月).
结论:
- 在移植前的患者中,甲状腺活检的发生性瘤率有所下降,符合成像指南.
- 接受活检的患者更早地接受了活检,从而加速了移植手术.
- 以指导方针为导向的工作确保了及时的癌症护理,并避免了这种人群的移植延迟.
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