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精准成像时代的甲状腺癌诊断

Thyroid cancer diagnosis in the era of precision imaging.

作者信息

Bonjoc Kimberley-Jane, Young Hannah, Warner Susanne, Gernon Thomas, Maghami Ellie, Chaudhry Ammar

机构信息

Department of Imaging Administration, City of Hope National Medical Center, Duarte, CA, USA.

Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.

出版信息

J Thorac Dis. 2020 Sep;12(9):5128-5139. doi: 10.21037/jtd.2019.08.37.

Abstract

Thyroid cancer affects 1.3% of the population with increasing rates of incidence over the last decade (approximately 2% per year). Although the overall prognosis is good in the differentiated subtypes, there has been a slow but steady increase in rate of deaths associated with thyroid cancer (approximately 0.7% per year over the last decade). Thyroid cancer is usually detected when: (I) patients feel a lump in the neck; (II) a routine clinical exam is performed; (III) an incidental thyroid nodule is identified on diagnostic imaging (e.g., CT neck or chest, carotid ultrasound, PET scan acquired for non-thyroid pathology). Identification of suspicious thyroid nodules results in further diagnostic work-up including laboratory assessment, further imaging, and biopsy. Accurate diagnosis is required for clinical staging and optimal patient treatment design. In this review, we aim to discuss utility of various imaging modalities and their role in thyroid cancer diagnosis and management. Additionally, we aim to highlight emerging diagnostic techniques that aim to improve diagnostic specificity and accuracy in thyroid cancer, thus paving way for precision medicine.

摘要

甲状腺癌影响着1.3%的人口,在过去十年中发病率呈上升趋势(每年约2%)。尽管分化型亚型的总体预后良好,但与甲状腺癌相关的死亡率一直在缓慢但稳步上升(过去十年中每年约0.7%)。甲状腺癌通常在以下情况被发现:(I)患者感觉到颈部有肿块;(II)进行常规临床检查;(III)在诊断成像中发现意外的甲状腺结节(例如,颈部或胸部CT、颈动脉超声、因非甲状腺病变进行的PET扫描)。发现可疑的甲状腺结节会导致进一步的诊断检查,包括实验室评估、进一步成像和活检。准确诊断对于临床分期和优化患者治疗方案至关重要。在本综述中,我们旨在讨论各种成像方式的效用及其在甲状腺癌诊断和管理中的作用。此外,我们旨在强调旨在提高甲状腺癌诊断特异性和准确性的新兴诊断技术,从而为精准医学铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35e0/7578495/461a9ce3bf7f/jtd-12-09-5128-f1.jpg

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