重视甲状腺结节的正确评估和随访

Attach importance to the appropriate evaluation and follow-up of thyroid nodules

甲状腺结节发病率高,是甲状腺外科临床中最常见的疾病。正确评估和随访甲状腺结节十分重要,有利于改善病人预后、节约医疗成本和优化资源分配。甲状腺结节的评估和随访主要包括临床评估、实验室、影像学和细胞学检查。临床评估中应该重点了解有无甲状腺癌家族史、颈部放射史和结节压迫所致的症状;促甲状腺激素(TSH)是初步评估甲状腺结节的首要的实验室检查;甲状腺超声检查是评估和随访甲状腺结节的单个最有价值的影像学检查;细针穿刺细胞学检查(FNA)是诊断甲状腺结节的金标准,在判断结节良恶性和决定下一步治疗方案上起着至关重要的作用。规范甲状腺结节的评估和随访有助于进一步提高甲状腺结节的诊治水平。

The incidence of thyroid nodules is high, and thyroid nodule is the most common disease during the thyroid surgical practice. Appropriate evaluation and follow-up of thyroid nodules are of critical importance for improving the prognosis, saving medical cost and optimizing the distribution of the medical resources. Evaluation and follow-up of thyroid nodules involve clinical assessment, laboratory studies, imaging studies and fine needle aspiration （FNA）. Attention should be put on a family history with thyroid carcinoma, a history of neck radiation and symptoms of compression caused by nodules during the clinical assessment. TSH is the initial and the most important laboratory study. Thyroid ultrasound is the single most valuable imaging test to evaluate and follow up the thyroid nodules. FNA is the gold standard for the diagnosis of thyroid nodules, playing a key role in differentiating the benign and malignant nodules and determining the treatment strategy. Standardized evaluation and follow-up of thyroid nodules will help to improve the diagnosis and treatment for patients with thyroid nodules.