Zafon Carles, Díez Juan J, Galofré Juan C, Cooper David S
Department of Endocrinology, Hospital Vall d'Hebron, and Diabetes and Metabolism Research Unit, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona and CIBERDEM (ISCIII), Barcelona, Spain.
Department of Endocrinology and Nutrition, Hospital Ramón y Cajal, Madrid, Spain.
Eur Thyroid J. 2017 Apr;6(2):65-74. doi: 10.1159/000457793. Epub 2017 Mar 3.
The management of thyroid nodules, one of the main clinical challenges in endocrine clinical practice, is usually straightforward. Although the most important concern is ruling out malignancy, there are grey areas where uncertainty is frequently present: the nodules labelled as indeterminate by cytology and the extent of therapy when thyroid cancer is diagnosed pathologically. There is evidence that the current available precision medicine tools (from all the "-omics" to molecular analysis, fine-tuning imaging or artificial intelligence) may help to fill present gaps in the future. We present here a commentary on some of the current challenges faced by endocrinologists in the field of thyroid nodules and cancer, and illustrate how precision medicine may improve their diagnostic and therapeutic capabilities in the future.
甲状腺结节的管理是内分泌临床实践中的主要临床挑战之一,通常较为直接。尽管最重要的是排除恶性肿瘤,但仍存在一些常常存在不确定性的灰色地带:细胞学标记为不确定的结节以及病理诊断为甲状腺癌时的治疗范围。有证据表明,当前可用的精准医学工具(从所有的“组学”到分子分析、精细成像或人工智能)可能有助于在未来填补当前的空白。我们在此对内分泌学家在甲状腺结节和癌症领域目前面临的一些挑战进行评论,并说明精准医学如何在未来提高他们的诊断和治疗能力。