不确定的甲状腺结节的超声波图案与细胞的流行
Sium Wolde Sellasie1,2, Stefano Amendola1, Leo Guidobaldi3
1Division of Endocrinology and Diabetes, CTO Andrea Alesini Hospital, Department of Surgical Sciences, University of Rome Tor Vergata, 00153 Rome, Italy.
Journal of clinical medicine
|August 14, 2025
概括
富含瘤细胞的不确定的甲状腺结节 (O-ITNs) 在超声波 (US) 上通常看起来是良性的,并且显示出较少的分类矛盾. 然而,美国的风险分层无法在O-ITN中可靠地区分恶性瘤风险.
科学领域:
- 内分泌学 在内分泌学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 不确定的甲状腺结节 (ITNs) 带来了诊断上的挑战.
- 富含细胞的ITN (O-ITN) 存在特殊的分类和管理困难.
- 对O-ITN进行标准化风险分层至关重要.
研究的目的:
- 评估超声波 (美国) 特性和美国放射学学院甲状腺成像报告和数据系统 (ACR TI-RADS) 在O-ITN中的风险.
- 为了比较贝塞斯达甲状腺细胞病理报告系统 (BSRTC) 和意大利甲状腺细胞病理分类和报告共识 (ICCRTC) 的O-ITNs.
- 分析O-ITNs细胞学分类系统对临床管理的影响.
主要方法:
- 177个ITN (TIR3A/TIR3B) 的回顾性分析,其中70%以上是细胞.
- 使用ACR TI-RADS对美国特征的评估.
- 使用BSRTC进行重新分类,并与ICCRTC进行临床病例管理 (CCM) 的比较.
主要成果:
- O-ITNs占结节的47.5%,显示出更大的尺寸和更低风险的美国特征 (ACR TI-RADS 3).
- 在O-ITNs中的ACR TI-RADS类中没有恶性瘤 (ROM) 的风险增加.
- 在O-ITNs的47.1%的组织学恶性瘤;较低的分类不一致性 (20.2%) 与非O-ITNs (38.7%) 相比.
结论:
- O-ITN表现出良性的美国特征,并减少了BSRTC和ICCRTC之间的分类不一致.
- 在O-ITN中,ACR TI-RADS未能对恶性瘤风险进行分层.
- 结合细胞学和仔细的US解释的量身定制方法对于管理O-ITNs至关重要.
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