不确定性甲状腺结节的临床管理需要重新审视. 为个性化解决问题的方法提供新的证据
Tommaso Piticchio1,2, S Wolde Sellasie3,4, F D'Arrigo5
1Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, Catania, Italy. tommaso.piticchio@phd.unict.it.
Journal of endocrinological investigation
|December 4, 2024
概括
重复细针吸气细胞学 (FNAC) 对于不确定的甲状腺结节 (ITNs) 通常是没有用处的. 十年的随访足够,避免对大多数患者进行终身监测.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 细胞病理学 细胞病理学
背景情况:
- 不确定的甲状腺结节 (ITNs),分类为TIR3A或III类,缺乏明确的管理指南.
- 这种模糊性往往导致重复细针吸收细胞学 (FNAC) 和长时间的随访,消耗大量资源.
研究的目的:
- 评估在ITN患者中重复FNAC的实用性.
- 评估ITN10年随访协议的安全性和有效性.
主要方法:
- 一项回顾性研究,涉及506名来自意大利两个高等中心的患者,他们接受了ITN的重复FNAC.
- 分析影响管理指示 (CMI) 和随访期间结果变化的因素.
主要成果:
- 重复FNAC仅在30个案例中导致管理指示发生变化,这是一个不显著的发现 (p=0.36).
- 与CMI相关的因素包括年龄较小,结节边缘和回声性.
- 在没有CMI的病例中,20/476需要手术,只有4例恶性病例,所有病例都发生在前8年内.
结论:
- 对ITN重复FNAC在很大程度上是不必要的,应该保留给具有可疑结节特征的年轻人.
- 十年的跟进期足以管理ITN,取代了终身监控的需要.
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