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海湾合作委员会国家甲状腺结节管理实践。

Practice of thyroid nodule management in the Gulf Cooperation Council countries.

机构信息

Division of Endocrinology, Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.

出版信息

Saudi Med J. 2021 Jan;42(1):66-74. doi: 10.15537/smj.2021.1.25591.

Abstract

To assessed the current practices for the management of thyroid nodules in the Gulf Cooperation Council (GCC) countries. Methods: We conducted a descriptive web-based survey to physicians and surgeons involved in the management of thyroid nodules. The survey included questions on referral, ultrasound (US) reporting, fine needle aspiration (FNA), management of thyroid nodules including the approach for indeterminate FNA results, and usage of molecular testing. Results: A total of 311 responders, 155 (49.8%) were endocrinologists. Results showed that referrals and US report lack a number of valuable information including family history (84.9%) and high-risk US features (92.9%). Approximately 263 (84.6%) preferred to include a scoring system or protocol to assess the nodule risk in US report. Approximately 193 (62.1%) sent the patient to interventional radiologists for FNA. Almost half (n=147, 47.3%) repeat the FNA in 2-3 months if the FNA result was a follicular lesion or atypia of undetermined significance and 142 (45.7%) opted for lobectomy for follicular neoplasm or suspicious of follicular neoplasm result. Only 44 (14.1%) performed molecular testing; however, 174 (55.9%) preferred it available. Significant variations in the approach were seen between endocrinologists versus non-endocrinologists. Conclusion: Practices variation in the management of thyroid nodules mandate a common practical guideline. Molecular testing is a preferable test for indeterminate FNA results by most of the responders though it is not widely available.

摘要

评估海湾合作委员会 (GCC) 国家甲状腺结节管理的当前实践。方法:我们对参与甲状腺结节管理的医生和外科医生进行了描述性的网络调查。调查包括转诊、超声 (US) 报告、细针穿刺抽吸术 (FNA)、甲状腺结节管理(包括不确定的 FNA 结果的处理方法)以及分子检测的使用。结果:共有 311 名应答者,其中 155 名(49.8%)是内分泌学家。结果表明,转诊和 US 报告缺乏许多有价值的信息,包括家族史(84.9%)和高危 US 特征(92.9%)。大约 263 名(84.6%)更愿意在 US 报告中包含评分系统或方案来评估结节风险。大约 193 名(62.1%)将患者转介给介入放射科医生进行 FNA。如果 FNA 结果为滤泡性病变或意义未明的不典型性,近一半(n=147,47.3%)会在 2-3 个月后重复 FNA,如果 FNA 结果为滤泡性肿瘤或疑似滤泡性肿瘤,则有 142 名(45.7%)选择进行叶切除术。只有 44 名(14.1%)进行了分子检测;然而,有 174 名(55.9%)更倾向于进行分子检测。内分泌学家与非内分泌学家之间在甲状腺结节管理方法上存在显著差异。结论:甲状腺结节管理实践中的差异需要制定共同的实用指南。尽管分子检测尚未广泛应用,但大多数应答者更愿意将其作为不确定的 FNA 结果的首选检测方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4120/7989305/59721a0a7178/SaudiMedJ-42-66-g004.jpg

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