Do Cao Christine, Haissaguerre Magalie, Lussey-Lepoutre Charlotte, Donatini Gianluca, Raverot Véronique, Russ Gilles
Department of Endocrinology, Diabetology and Metabolism, Lille University Hospital, CHU Lille, Lille, France.
Department of Endocrinology and Endocrine Oncology, Haut Lévêque Hospital, Bordeaux University Hospital, Pessac, France.
Ann Endocrinol (Paris). 2022 Dec;83(6):380-388. doi: 10.1016/j.ando.2022.10.009. Epub 2022 Oct 21.
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). This section deals with the initial work-up for thyroid nodules in adult patients, including clinical and biological evaluation, standardized ultrasound characterization and EU-TIRADS-based nodule selection for fine-needle aspiration biopsy. Indications for thyroid core-biopsies or open surgical biopsies and for cross-sectional imaging of the neck and upper chest are also mentioned.
《2022年法国内分泌学会-法国内分泌外科学会-法国核医学学会关于甲状腺结节管理的共识》涉及甲状腺结节的管理，甲状腺结节是内分泌科常见的就诊原因。在超过90%的病例中，患者甲状腺功能正常，结节为良性且无进展，无需特殊治疗。临床医生的目标是检测出有复发和死亡风险的恶性甲状腺结节、导致甲状腺功能亢进的毒性结节或需要治疗的压迫性结节。甲状腺结节的诊断和治疗需要内分泌科医生、核医学医生和外科医生密切合作，但也涉及其他专科医生。因此，本共识声明由3个学会联合制定：法国内分泌学会（SFE）、法国内分泌外科学会（AFCE）和法国核医学学会（SFMN）；各个工作组包括来自其他专科（病理学家、放射科医生、儿科医生、生物学家等）的专家。本节讨论成年患者甲状腺结节的初始检查，包括临床和生物学评估、标准化超声特征描述以及基于欧盟甲状腺影像报告和数据系统（EU-TIRADS）的细针穿刺活检结节选择。还提到了甲状腺粗针活检或开放手术活检以及颈部和上胸部横断面成像的适应证。
