Contemporary Thyroid Nodule Evaluation and Management

甲状腺结节 医学 过度诊断 恶性肿瘤 结核(地质) 放射科 甲状腺 活检 背景(考古学) 甲状腺癌 病理 内科学 生物 古生物学
作者
Giorgio Grani,Marialuisa Sponziello,Valeria Pecce,Valeria Ramundo,Cosimo Durante
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [The Endocrine Society]
卷期号:105 (9): 2869-2883 被引量:189
标识
DOI:10.1210/clinem/dgaa322
摘要

Abstract Context Approximately 60% of adults harbor 1 or more thyroid nodules. The possibility of cancer is the overriding concern, but only about 5% prove to be malignant. The widespread use of diagnostic imaging and improved access to health care favor the discovery of small, subclinical nodules and small papillary cancers. Overdiagnosis and overtreatment is associated with potentially excessive costs and nonnegligible morbidity for patients. Evidence Acquisition We conducted a PubMed search for the recent English-language articles dealing with thyroid nodule management. Evidence Synthesis The initial assessment includes an evaluation of clinical risk factors and sonographic examination of the neck. Sonographic risk-stratification systems (e.g., Thyroid Imaging Reporting and Data Systems) can be used to estimate the risk of malignancy and the need for biopsy based on nodule features and size. When cytology findings are indeterminate, molecular analysis of the aspirate may obviate the need for diagnostic surgery. Many nodules will not require biopsy. These nodules and those that are cytologically benign can be managed with long-term follow-up alone. If malignancy is suspected, options include surgery (increasingly less extensive), active surveillance or, in selected cases, minimally invasive techniques. Conclusion Thyroid nodule evaluation is no longer a 1-size-fits-all proposition. For most nodules, the likelihood of malignancy can be confidently estimated without resorting to cytology or molecular testing, and low-frequency surveillance is sufficient for most patients. When there are multiple options for diagnosis and/or treatment, they should be discussed with patients as frankly as possible to identify an approach that best meets their needs.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
2秒前
NONO完成签到 ,获得积分10
2秒前
Joseph发布了新的文献求助10
3秒前
搜集达人应助QQ采纳,获得10
3秒前
Tina泽完成签到,获得积分10
4秒前
快乐的厉发布了新的文献求助10
4秒前
5秒前
负责的花瓣应助独爱小新采纳,获得10
5秒前
大模型应助独爱小新采纳,获得10
5秒前
6秒前
哇哈哈完成签到,获得积分10
8秒前
acz完成签到,获得积分10
9秒前
9秒前
9秒前
9秒前
舒心平蝶发布了新的文献求助10
10秒前
墨闲君完成签到,获得积分10
11秒前
线性代数完成签到,获得积分10
13秒前
wisdom完成签到,获得积分10
13秒前
嗯嗯嗯嗯完成签到 ,获得积分10
14秒前
顾矜应助Hwjysh采纳,获得10
15秒前
llq发布了新的文献求助10
15秒前
16秒前
16秒前
16秒前
lemonlmm完成签到,获得积分0
16秒前
16秒前
hx60606发布了新的文献求助10
16秒前
帅气的盼易完成签到,获得积分10
18秒前
gyx完成签到,获得积分10
18秒前
方若剑应助科研通管家采纳,获得20
19秒前
柠檬完成签到,获得积分10
19秒前
天天快乐应助科研通管家采纳,获得10
19秒前
李爱国应助科研通管家采纳,获得10
19秒前
打打应助科研通管家采纳,获得10
19秒前
无花果应助科研通管家采纳,获得10
19秒前
科研通AI2S应助科研通管家采纳,获得10
19秒前
桐桐应助科研通管家采纳,获得10
20秒前
传奇3应助高贵灵槐采纳,获得10
20秒前
高分求助中
The late Devonian Standard Conodont Zonation 2000
Nickel superalloy market size, share, growth, trends, and forecast 2023-2030 2000
The Lali Section: An Excellent Reference Section for Upper - Devonian in South China 1500
Smart but Scattered: The Revolutionary Executive Skills Approach to Helping Kids Reach Their Potential (第二版) 1000
Very-high-order BVD Schemes Using β-variable THINC Method 850
Mantiden: Faszinierende Lauerjäger Faszinierende Lauerjäger 800
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3249720
求助须知:如何正确求助?哪些是违规求助? 2892889
关于积分的说明 8274610
捐赠科研通 2561137
什么是DOI,文献DOI怎么找? 1389585
科研通“疑难数据库(出版商)”最低求助积分说明 651301
邀请新用户注册赠送积分活动 628010