Surgical Oncology Program, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States.
Front Endocrinol (Lausanne). 2020 Oct 9;11:590128. doi: 10.3389/fendo.2020.590128. eCollection 2020.
Cytologically indeterminate thyroid nodules remain a diagnostic and clinical challenge, and molecular testing has been advocated and advanced as a diagnostic modality to help guide treatment. While studies have expounded on the improved diagnostic certainty with these tests, data demonstrating meaningful clinical impact and supporting their routine use is still limited at best. In this review, we discuss the limitations regarding diagnostic accuracy, impact on surgical decision-making and outcomes, and cost-effectiveness of molecular testing. By highlighting the limitations of these tests, we aim to promote more thoughtful utilization of these tools in the management of thyroid nodules going forward.
甲状腺细胞学不确定结节仍然是一个诊断和临床挑战，分子检测被提倡并作为一种诊断方法来帮助指导治疗。虽然研究已经阐述了这些测试在提高诊断确定性方面的改进，但证明具有有意义的临床影响并支持其常规使用的数据仍然是有限的。在这篇综述中，我们讨论了分子检测在诊断准确性、对手术决策和结果的影响以及成本效益方面的局限性。通过强调这些测试的局限性，我们旨在促进在未来甲状腺结节管理中更明智地利用这些工具。
