AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES-2016 UPDATE
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES-2016 UPDATE
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DOI：
10.4158/ep161208.gl
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发表时间：
2016-05-01
影响因子：
4.2
通讯作者：
Vitti, Paolo
中科院分区：
文献类型：
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作者：
Gharib, Hossein;Papini, Enrico;Vitti, Paolo
在高达50%至60%的健康受试者中检测到甲状腺结节。大多数结节不会引起临床显著症状，因此，其管理的主要挑战是排除恶性肿瘤，超声检查（US）和细针穿刺（FNA）活检作为诊断的基石。这些指南中讨论的关键问题如下：（1）基于美国的恶性肿瘤风险分类和US引导的FNA（以下简称FNA）适应症，（2）FNA样本的细胞学分类，（3）免疫细胞化学和分子检测应用于甲状腺FNA的作用，（4）治疗选择，（5）随访策略。甲状腺结节的管理在怀孕期间和儿童也得到解决。根据超声特征，甲状腺结节可分为3组：低、中和高恶性风险。结节应考虑FNA
Thyroid nodules are detected in up to 50 to 60% of healthy subjects. Most nodules do not cause clinically significant symptoms, and as a result, the main challenge in their management is to rule out malignancy, with ultrasonography (US) and fine-needle aspiration (FNA) biopsy serving as diagnostic cornerstones. The key issues discussed in these guidelines are as follows: (1) US-based categorization of the malignancy risk and indications for US-guided FNA (henceforth, FNA), (2) cytologic classification of FNA samples, (3) the roles of immunocytochemistry and molecular testing applied to thyroid FNA, (4) therapeutic options, and (5) follow-up strategy. Thyroid nodule management during pregnancy and in children are also addressed. On the basis of US features, thyroid nodules may be categorized into 3 groups: low-, intermediateand high-malignancy risk. FNA should be considered for nodules