Madigan Army Medical Center Otolaryngology-Head & Neck Surgery, Tacoma, Washington, USA.
Madigan Army Medical Center Otolaryngology-Head & Neck Surgery, Tacoma, Washington, USA.
Surg Clin North Am. 2022 Apr;102(2):285-307. doi: 10.1016/j.suc.2021.12.006. Epub 2022 Mar 5.
Thyroid nodules are extremely common findings with a low likelihood of harboring a clinically significant malignancy. Ultrasound is highly sensitive at identifying which nodules warrant further workup with fine needle aspiration (FNA) biopsy. FNA should be performed based on US findings and risk categories. The Bethesda system should be used to classify FNA results. Molecular testing may be offered if the results are likely to change the therapeutic approach. Clinicians should be keenly aware of the potential for overtreatment and should make a concerted effort to factor patient values into the decision-making process.
甲状腺结节是一种非常常见的发现,其恶性肿瘤的临床可能性较低。超声在识别哪些结节需要进一步进行细针抽吸(FNA)活检方面具有高度的敏感性。FNA 应根据 US 发现和风险类别进行。应使用 Bethesda 系统对 FNA 结果进行分类。如果结果可能改变治疗方法,则可以提供分子检测。临床医生应该敏锐地意识到过度治疗的可能性,并应努力将患者的价值观纳入决策过程。