Radiologia Diagnostica ed Interventistica, Azienda Ospedaliera San Paolo, Milan, Italy.
Ultrasound Med Biol. 2013 Aug;39(8):1350-5. doi: 10.1016/j.ultrasmedbio.2013.02.464. Epub 2013 Jun 4.
This study was conducted to evaluate whether ultrasound characteristics of thyroid nodules with a known cytologic diagnosis of "follicular pattern" (indicative of follicular hyperplasia, follicular adenoma or follicular carcinoma) can be used to define a nodule malignancy score to limit surgery to selected, higher-risk cases. In pre-operative ultrasound results of patients diagnosed with a "follicular pattern" on cytology who subsequently underwent surgery, each nodule feature was given a score from 0 (most likely benign) to 2 (most likely malignant), resulting in a total score ranging from 0 to 11. The total nodule score (total malignancy score) was then compared with the definitive histologic diagnosis. According to our results, surgery is advisable in patients with score ≥4 (79% of carcinomas), ultrasound follow-up seems to be appropriate for patients with a score of 3 (21% of carcinomas) and no action is recommended for patients with score <3 (only benign nodules).
本研究旨在评估具有已知细胞学诊断为“滤泡模式”（提示滤泡增生、滤泡性腺瘤或滤泡癌）的甲状腺结节的超声特征是否可用于定义结节恶性评分，以将手术仅限于选定的高风险病例。在细胞学诊断为“滤泡模式”的患者的术前超声结果中，对随后接受手术的每个结节特征进行评分，从 0（最可能良性）到 2（最可能恶性），总分为 0 至 11 分。然后将总结节评分（总恶性评分）与明确的组织学诊断进行比较。根据我们的结果，对于评分≥4 的患者（79%的癌）建议手术，对于评分 3 的患者（21%的癌）超声随访似乎是合适的，而评分<3 的患者（仅为良性结节）则不建议采取任何行动。
