带有不确定的细胞学和负分子谱的甲状腺结节:恶性病发病率和监测实践范式
Sapir Nachum1, Isabella Tondi Resta2, Zubair Baloch2
1Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Thyroid : official journal of the American Thyroid Association
|January 28, 2025
概括
对甲状腺结节的分子检测显示,在不确定的情况下,3-23%的恶性瘤风险. 负面但有限的ThyroSeq v3结果要求重复细针吸收 (FNA) 活检.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 分子测试越来越多地用于甲状腺结节的不确定的细胞学.
- 这些测试的虚假阴性率和错过的恶性瘤现实数据有限.
研究的目的:
- 评估甲状腺结节中恶性瘤 (PoM) 的患病率,其细胞系不明 (贝塞斯达甲状腺细胞病理报告系统 (TBSRTC) III和IV) 和阴性,目前阴性或阴性但有限的ThyroSeq版本3 (TSv3) 结果.
- 评估这些结节的临床管理和监测实践.
主要方法:
- 556个甲状腺结节的回顾性研究与TBSRTC III/IV细胞学和TSv3结果 (2017年11月-2022年3月).
- 对切除结节的外科病理分析和超声波 (US) 监测数据.
- 基于所有结节 (低) 和手术切除结节 (高) 的PoM计算.
主要成果:
- 在分子良性TBSRTC III/IV结核中的PoM在3%到23%之间.
- 与TBSRTC III (低1.6%,高13%) 相比,TBSRTC IV分子良性结节的PoM (低7.3%,高48%) 较高.
- 与负结果相比,目前负的和负但有限的TSv3结果与更高的立即手术切除率有关.
结论:
- 在临床管理中应考虑TSv3的负子类型.
- 对于阴性但有限的TSv3样本,建议重复FNA活检.
- 对未切除的阴性和目前阴性结节进行最佳监测需要进一步调查;目前建议进行监测超声波.
相关概念视频
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The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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