PDF(Pubmed)
Abstract：
Thyroid nodules (TNs) are prevalent and found in up to 50% of individuals. While most TNs are benign, some can be malignant. The evaluation of TNs is crucial to rule out malignancy and identify those requiring surgical intervention. This study aimed to clarify the reported prevalence of TNs, focusing specifically on their various types, assessment and diagnostic processes, current evaluation methods, and evidence-based management. It also provides recommendations for follow-up. TNs are typically found during physical exams or incidentally during imaging procedures. Routine laboratory and clinical evaluations of TNs are common. Ultrasound is the preferred imaging method to determine if a TN needs a biopsy. Fine-needle aspiration (FNA) is crucial in deciding whether surgery or surveillance is necessary. TNs that show suspicious features on the ultrasound may require cytologic analysis to assess the risk of malignancy. The effectiveness of several supplementary molecular tests is still uncertain, although some studies report promising results. The management and treatment approach for TNs primarily depends on the results of FNA cytology and ultrasound characteristics. The optimal treatment strategy for TNs ranges from straightforward follow-ups for low-risk cases to surgical intervention for high-risk patients. Rather than adopting a uniform approach, clinicians should assess each patient on a case-by-case basis using current knowledge and a collaborative, multidisciplinary method.
摘要：
甲状腺结节(TNs)是普遍存在的,并且在高达50%的个体中发现。虽然大多数TNs是良性的，有些可能是恶性的。TNs的评估对于排除恶性肿瘤和确定需要手术干预的患者至关重要。本研究旨在阐明报告的TNs患病率，特别关注它们的各种类型，评估和诊断过程，当前的评估方法，和循证管理。报告还提出了后续行动建议。通常在身体检查期间或在成像过程期间偶然发现TNs。TNs的常规实验室和临床评估很常见。超声是确定TN是否需要活检的首选成像方法。细针抽吸术（FNA）对于决定是否需要手术或监视至关重要。在超声上显示可疑特征的TNs可能需要细胞学分析以评估恶性肿瘤的风险。几个补充分子测试的有效性仍然不确定，尽管一些研究报告了有希望的结果。TNs的管理和治疗方法主要取决于FNA细胞学结果和超声特征。TNs的最佳治疗策略范围从低风险病例的直接随访到高风险患者的手术干预。与其采取统一的方法，临床医生应该评估每个病人在个案的基础上使用现有的知识和合作，多学科方法。
