贝塞斯达V甲状腺结节的指导管理:分子检测的作用
Idit Tessler1,2, Grégoire B Morand3,4, Nir A Gecel2
1Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Ramat Gan, Israel.
Clinical endocrinology
|September 18, 2025
概括
分子分析有助于贝塞斯达V甲状腺结节的风险分层. 与低风险变体相比,中等风险变体显著增加了侵袭性疾病的可能性.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 分子诊断学 分子诊断
背景情况:
- 2023年贝塞斯达系统更新包括对贝塞斯达V细胞学结节的分子测试.
- 这旨在改善甲状腺病变的手术决策.
研究的目的:
- 研究贝塞斯达V甲状腺结节中分子分析和恶性瘤攻击性之间的相关性.
- 评估分子测试在完善这些病变的风险分层中的有用性.
主要方法:
- 对156名贝塞斯达V细胞学和恶性组织学患者进行了回顾性多中心研究.
- 进行了分子分析,并使用2015年ATA指南评估恶性瘤的攻击性.
- 基因变异被分为不同风险级别 (没有,低,中等,高).
主要成果:
- 在161个贝塞斯达V结节中,95%是恶性.
- 分子分析显示39.7%的患者没有突变,31.4%的患者低风险,28.8%的患者中等风险.
- 中级风险变体与侵袭性疾病风险增加六倍相关 (49%与8.2%,p<0.001).
结论:
- 分子分析为贝塞斯达V甲状腺病变提供了有价值的风险分层.
- 在低风险分子组中观察到非常低的侵略性病理的发生率.
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