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细胞学上低风险的不确定的甲状腺结节的自然史
Marsida Teliti1,2, Spyridon Chytiris2, Francesca Coperchini1
1Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
The Journal of clinical endocrinology and metabolism
|January 29, 2025
概括
积极监测是低风险的不确定的甲状腺结节 (TIR3A) 的安全管理策略. 重复精细针吸收活检 (FNAB) 有助于完善诊断,避免对这些通常不的结节进行不必要的手术.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 诊断细胞病理学诊断细胞病理学
背景情况:
- 作为TIR3A (低风险不确定) 分类的甲状腺结节,由于不确定的恶性瘤潜力,造成诊断挑战.
- 精细针吸收活检 (FNAB) 是主要的诊断工具,但TIR3A结果需要谨慎的管理策略.
研究的目的:
- 评估TIR3A甲状腺结节的自然史和结果.
- 评估保守管理的安全性和有效性,并对TIR3A结节重复FNAB.
主要方法:
- 在2017年7月至2019年12月期间通过FNAB诊断出TIR3A结节的371名患者的回顾性分析.
- 评估包括基线和随访超声波 (US) 参数和临床数据.
- 患者通过手术,保守的随访或重复FNAB进行管理.
主要成果:
- 在TIR3A结节中,恶性瘤的总体发病率为16.5%.
- 重复FNAB在40%的病例中改善了诊断准确性,恶性瘤检测率增加了5%.
- 包括临床和美国随访在内的保守管理,在平均3.3年内没有显著的结节变化.
结论:
- 积极监测是管理TIR3A甲状腺结节的安全和可行的选择,特别是在没有额外的风险因素的情况下.
- 重复FNAB在优化手术决策和减少不必要的干预方面发挥着至关重要的作用.
- TIR3A结节通常表现出惰的行为,支持保守的管理方法.
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