重视良性甲状腺结节的合理应对

Optimal management of benign thyroid nodules

甲状腺结节已成为常见病，大部分结节经过超声影像和甲状腺细针穿刺活检（FNAB）鉴定可陂确认为良性病变。考虑到超声引导下的FNAB细胞学结果假阴性率低，及随访中基于超声模型能发现更多遗漏的甲状腺癌，细胞学良性结节应进行超声随访。一旦出现结节生长或新的恶性征象，可考虑再次实施FNAB。良性结节的治疗方法主要包括药物、经皮无水酒精注射、热消融和手术。应充分权衡良性甲状腺结节治疗的获益和风险，避免过度治疗。

Thyroid nodules are a common clinical problem, the majority of which are regarded as benign nodules by initial fine-needle aspiration biopsy （ FNAB ） or ultrasound characteristics. Given the low false negative rate of ultrasound-guided FNAB cytology and the higher yield of missed malignancies based upon nodule sonographic pattern, a routine sonographic surveillance is recommended to the thyroid nodules with benign cytology. If there are any sonographic evidence of growth or development of new suspicious sonographic features, the FNAB could be repeated. Treatment for benign thyroid nodules includes medications, percutaneous ethanol injection, thermal ablation and surgery. In order to avoid over-treatment, the potential harm and benefits of any intervention should be assessed.