分子检测在甲状腺结节良恶性诊断中的研究进展

Research Advances in Molecular Detection in Diagnosis of Benign and Malignant Thyroid Nodules

近年来,甲状腺癌已成为增长速度最快的恶性肿瘤之一。甲状腺结节的术前超声检查是诊断甲状腺结节最经济有效的筛查手段,超声引导下的细针穿刺细胞学(FNA)在区分甲状腺结节良恶性方面具有较高的敏感性和特异性,但仍有25%左右无法通过FNA确定性质,导致一部分不必要的手术,为了避免过度诊疗,鉴别甲状腺结节的良恶性对于患者的预后至关重要,因此需要进一步行分子标志物检测以提高诊断准确性,分子检测已成为当前研究热点。常规超声检查及分子检测技术在诊断甲状腺结节方面各有优缺点,但常规超声、FNA以及分子检测技术等多种方法相联合有助于提高不确定结节术前诊断的准确性,同时也有助于甲状腺结节的个体化治疗。

In recent years,thyroid cancer has become one of the fastest-growing malignant tumors.Preoperative ultrasound is the most economic and efficient screening diagnosis of thyroid nodules,and fine needle aspiration(FNA)under ultrasound guidance is highly sensitive and specific in distinguishing benign and malignant thyroid gland,although about 25%still cannot be determined by FNA,which has caused some unnecessary surgical complications.To avoid over diagnosis and treatment,differentiating benign from malignant thyroid nodules is essential for prognosis.So further molecular marker detection is needed to improve the diagnosis accuracy,and the molecular detection has become the current hotspot.Routine ultrasound examination and molecular detection techniques in the diagnosis of thyroid nodules each have advantages and disadvantages,but the combination of conventional ultrasonic,FNA and molecular detection methods helps to improve the preoperative diagnostic accuracy of indeterminate thyroid nodules,which also helps to the individualized treatment.