Führer D, Mügge C, Paschke R
IIIrd Medical Department, University of Leipzig, Leipzig, Germany.
Exp Clin Endocrinol Diabetes. 2005 Mar;113(3):152-9. doi: 10.1055/s-2005-837523.
Nodular thyroid disease is highly prevalent in iodine deficient areas. In Germany it affects approximately 30 % of the adult population. Differential diagnosis of thyroid nodules is directed at exclusion of rare thyroid malignancy and assessment of the nodules' functional characteristics in order to determine the best treatment approach. In 2003 the annual meeting of the Sektion Schilddrüse, a thyroid specialist group of the German Society of Endocrinology addressed the topic of "management of benign nodular thyroid disease". To assess the current diagnostic and therapeutic approach to nodular thyroid disease by German thyroid experts we designed a questionnaire, which was sent to all members of the Thyroid Section before the meeting and was answered by 70 % of the participants. We here report the results of the questionnaire, which show a considerable national heterogeneity in the management of thyroid nodules as well as diagnostic and treatment preferences for different thyroid specialist subgroups, e.g. endocrinologists and nuclear medicine specialist. This is in agreement with results of previous questionnaires assessing state-of-the-art practise among members of the European and American Thyroid Associations and underlines the definite need for a consensus process and for carefully planned randomized trials to answer the many unresolved questions in diagnosis and therapy of nodular thyroid disease.
结节性甲状腺疾病在碘缺乏地区极为普遍。在德国,约30%的成年人口受其影响。甲状腺结节的鉴别诊断旨在排除罕见的甲状腺恶性肿瘤,并评估结节的功能特征,以确定最佳治疗方案。2003年,德国内分泌学会甲状腺专家小组——甲状腺科年会探讨了“良性结节性甲状腺疾病的管理”这一主题。为评估德国甲状腺专家对结节性甲状腺疾病当前的诊断和治疗方法,我们设计了一份问卷,在会议召开前发送给了甲状腺科的所有成员,70%的参与者进行了回复。我们在此报告问卷结果,结果显示在甲状腺结节的管理方面存在相当大的全国性差异,以及不同甲状腺专科亚组(如内分泌科医生和核医学专家)的诊断和治疗偏好。这与之前评估欧美甲状腺协会成员最新实践情况的问卷结果一致,并强调了达成共识过程以及精心规划随机试验的明确必要性,以回答结节性甲状腺疾病诊断和治疗中许多未解决的问题。