在甲状腺结节的分子检测:它改变了多少临床实践?
Mehmet Kostek1, Niranjna Swaminathan1, Azeem Izhar1
1Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Biomedicines
|August 28, 2025
概括
临床因素如压缩症状,甲状腺功能过高和结节大小会影响甲状腺切除术的决定,即使是良性分子检测. 这些因素可能表明,在某些甲状腺结节病例中,可以省略分子测试.
科学领域:
- 内分泌学
- 癌症学
- 分子诊断
背景情况:
- 分子检测有助于评估甲状腺结节的细针吸收活检 (FNAB).
- 当有明确的迹象时,甲状腺切除术的临床决定可以取代良性分子测试结果.
研究的目的:
- 鉴定导向甲状腺切除决定的临床因素,尽管甲状腺结节的良性分子测试结果.
- 评估分子测试在管理不确定的甲状腺结节中的有用性.
主要方法:
- 对177名贝塞斯达III/IVFNAB和良性Afirma分子测试结果的回顾性审查 (2016年1月至2024年1月).
- 对人口,临床,超声波和病理数据的分析.
- 观察与甲状腺切除组的比较,使用基平方和多变量逻辑回归.
主要成果:
- 在50. 9%的患者中进行了甲状腺切除术.
- 与手术独立相关的因素包括压缩症状 (OR: 23. 2),甲状腺功能过高 (OR: 5. 87),结节> 4厘米 (OR: 11. 36) 和结节生长 (OR: 7. 85).
结论:
- 良性分子检测结果在出现压缩症状,甲状腺功能障碍,大结节 (> 4 cm) 或结节生长时不排除甲状腺切除术.
- 在这些特定场景中,分子测试可能具有有限的临床实用性,这表明可能会省略以提高成本效益.
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