Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12(th) Avenue, Miami, FL 33136, USA. Electronic address: https://twitter.com/JaylouVelez.
Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12(th) Avenue, Miami, FL 33136, USA. Electronic address: https://twitter.com/Y_Tjendra.
Surg Pathol Clin. 2023 Mar;16(1):1-14. doi: 10.1016/j.path.2022.09.003. Epub 2022 Dec 8.
Risk stratification is essential in the preoperative evaluation and management of thyroid nodules, most of which are benign. Advances in DNA and RNA sequencing have shed light on the molecular drivers of thyroid cancer. Molecular testing of cytologically indeterminate nodules has helped refine risk stratification, triage patients for surgery, and determine the extent of surgery. Molecular platforms with high negative predictive values can help identify nodules that may be spared surgery and can be managed conservatively. Here we discuss the importance of integrating cytomorphologic, molecular, and histologic features to help avoid errors and improve patient management.
风险分层在甲状腺结节的术前评估和管理中至关重要，大多数甲状腺结节都是良性的。DNA 和 RNA 测序的进展揭示了甲状腺癌的分子驱动因素。对细胞学不确定的结节进行分子检测有助于完善风险分层，为手术患者进行分诊，并确定手术范围。具有高阴性预测值的分子平台有助于识别可能免于手术且可以保守治疗的结节。在这里，我们讨论了整合细胞形态学、分子和组织学特征的重要性，以帮助避免错误并改善患者管理。
