[甲状腺结节的二次预防中的超声波-证据,益处和局限性]
Felix Werner1, Susann Hueber1, Sarina Katrin Müller2
1Allgemeinmedizinisches Institut, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Deutschland.
HNO
|December 30, 2025
概括
在无症状的成年人中不建议对甲状腺结节进行超声波查. 虽然很常见,但大多数结节都是良性的,查导致过度诊断而不降低死亡率.
科学领域:
- 内分泌学 在内分泌学.
- 诊断成像 诊断成像 诊断成像
- 公共卫生 公共卫生
背景情况:
- 甲状腺结节是超声波检查期间经常发现的偶然发现.
- 目前的证据表明,早期超声波检测对于二次预防没有显著的患者益处.
研究的目的:
- 审查关于超声波对甲状腺结节的二次预防的益处和危害的国际证据.
- 为了告知临床实践和关于甲状腺结节查的指导方针.
主要方法:
- 进行了主要国际和国家甲状腺协会 (如ATA,ETA,USPSTF) 的指导方针的叙述性审查.
- 包括基于人口的研究 (SHIP,KORA,SEER) 的分析和2010-2025年间发表的系统性审查/元分析.
主要成果:
- 甲状腺结节的患病率很高,但临床上显著或恶性发现率很低.
- 超声波查增加了无效乳头癌的检测,但没有降低死亡率,导致严重的过度诊断和过度治疗风险.
- 国际指南不建议对无症状成年人进行查;对于疑似病例,标准化风险分类 (例如,EU-TIRADS,ACR TIRADS) 是至关重要的.
结论:
- 由于过度诊断率高,不建议对无症状个体进行超声波查.
- 通过查来降低甲状腺癌发病率或死亡率的已被证明的益处尚未确定.
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