Kakudo Kennichi, Jung Chan Kwon, Liu Zhiyan, Hirokawa Mitsuyoshi, Bychkov Andrey, Vuong Huy Gia, Keelawat Somboon, Srinivasan Radhika, Hang Jen-Fan, Lai Chiung-Ru
Department of Pathology, Cancer Genome Center and Thyroid Disease Center, Izumi City General Hospital, Izumi, Osaka, Japan.
Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Pathol Transl Med. 2023 Nov;57(6):289-304. doi: 10.4132/jptm.2023.10.04. Epub 2023 Nov 14.
The Asian Thyroid Working Group was founded in 2017 at the 12th Asia Oceania Thyroid Association (AOTA) Congress in Busan, Korea. This group activity aims to characterize Asian thyroid nodule practice and establish strict diagnostic criteria for thyroid carcinomas, a reporting system for thyroid fine needle aspiration cytology without the aid of gene panel tests, and new clinical guidelines appropriate to conservative Asian thyroid nodule practice based on scientific evidence obtained from Asian patient cohorts. Asian thyroid nodule practice is usually designed for patient-centered clinical practice, which is based on the Hippocratic Oath, "First do not harm patients," and an oriental filial piety "Do not harm one's own body because it is a precious gift from parents," which is remote from defensive medical practice in the West where physicians, including pathologists, suffer from severe malpractice climate. Furthermore, Asian practice emphasizes the importance of resource management in navigating the overdiagnosis of low-risk thyroid carcinomas. This article summarizes the Asian Thyroid Working Group activities in the past 7 years, from 2017 to 2023, highlighting the diversity of thyroid nodule practice between Asia and the West and the background reasons why Asian clinicians and pathologists modified Western systems significantly.
亚洲甲状腺工作组于2017年在韩国釜山举行的第12届亚洲大洋洲甲状腺协会(AOTA)大会上成立。该小组的活动旨在描述亚洲甲状腺结节的诊疗情况,建立甲状腺癌的严格诊断标准、无需基因检测辅助的甲状腺细针穿刺细胞学报告系统,以及基于从亚洲患者队列中获得的科学证据制定适合亚洲保守甲状腺结节诊疗的新临床指南。亚洲甲状腺结节诊疗通常以患者为中心进行临床实践,其依据是希波克拉底誓言“首先,不要伤害患者”以及东方的孝道“不要伤害自己的身体,因为它是父母给予的珍贵礼物”,这与西方的防御性医疗实践截然不同,在西方,包括病理学家在内的医生面临着严重的医疗事故环境。此外,亚洲的诊疗方法强调在应对低风险甲状腺癌过度诊断时资源管理的重要性。本文总结了亚洲甲状腺工作组在2017年至2023年过去7年中的活动,突出了亚洲和西方甲状腺结节诊疗的差异以及亚洲临床医生和病理学家大幅修改西方系统的背景原因。