超声波上甲状腺结节大小的时间趋势:系统性审查和元分析
Hayley Mann1, Natalia Arroyo2, Vivian Hsiao3
1Division of Otolaryngology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison.
JAMA otolaryngology-- head & neck surgery
|October 24, 2024
概括
自1990年以来,诊断超声波上的甲状腺结节大小每年都在增加. 然而,查超声波研究显示报告的结节大小下降,质疑小结节的临床相关性.
科学领域:
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 人们越来越担心甲状腺癌的过度检测.
- 最近更新的甲状腺结节风险分层和指导方针旨在提高诊断准确性.
- 这些变化对通过超声波报告的甲状腺结节大小的影响尚不清楚.
研究的目的:
- 评估自1990年以来报告的甲状腺结节大小的变化.
- 为了比较诊断和查超声波研究之间的结节大小趋势.
主要方法:
- 原始研究研究的系统审查和元分析.
- 包括成人第一次接受甲状腺超声波检查.
- 在PubMed,SCOPUS,CENTRAL和CINAHL中从1990年1月到2021年3月进行搜索.
- 使用混合效应元回归来分析平均结节大小.
主要成果:
- 包括18项研究中的11,963名患者.
- 平均结节大小每年整体增加0.52毫米 (1990-2021年).
- 诊断子组:平均结节大小每年增加0.57毫米.
- 查小组:平均结节大小每年减少0.23毫米,直到2012年.
结论:
- 诊断性超声波显示甲状腺结节大小增加,可能是由于指导方针的变化.
- 查研究表明普遍存在,易于识别的亚厘米结节,具有可疑的临床相关性.
- 这些发现为未来的甲状腺结节管理指南和政策提供了信息.
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