Li X Y, Zhang B, Lin Y S
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy Of Medical Sciences, Beijing 100730, China.
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy Of Medical Sciences, Beijing 100730, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Apr 7;52(4):309-315. doi: 10.3760/cma.j.issn.1673-0860.2017.04.018.
The prevalence of thyroid nodules, especially differentiated thyroid cancer, has increased during the past decades. With the consideration of increasing prevalence of the diseases, American Thyroid Association (ATA) updated the guidelines for adult patients with thyroid nodules and differentiated thyroid carcinoma (DTC) in 2015. The aim of the new guidelines was to minimize potential harm from overtreatment in majority of patients at low risk for diseasespecific mortality and morbidity while appropriately treat and monitor those patients at higher risk. The updates of contents in new ATA guidelines are interpreted in this article, including the contents about screening, diagnosis and treatment plan of nodules, initial surgical treatment of DTC, the evaluation and treatment of DTC after surgery, follow-up and diagnosis and treatment of recurrence, persistence, and distant metastasis of DTC.
在过去几十年中,甲状腺结节尤其是分化型甲状腺癌的患病率有所上升。鉴于这些疾病的患病率不断增加,美国甲状腺协会(ATA)于2015年更新了成人甲状腺结节和分化型甲状腺癌(DTC)患者的指南。新指南的目的是在最大程度上减少疾病特异性死亡率和发病率低风险的大多数患者过度治疗带来的潜在危害,同时对高风险患者进行适当的治疗和监测。本文对新ATA指南中的内容更新进行了解读,包括结节的筛查、诊断和治疗计划、DTC的初始手术治疗、手术后DTC的评估和治疗、DTC复发、持续存在和远处转移的随访以及诊断和治疗等内容。