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Use of strain ultrasound elastography versus fine-needle aspiration cytology for the differential diagnosis of thyroid nodules: a retrospective analysis.

应变超声弹性成像与细针穿刺细胞学检查在甲状腺结节鉴别诊断疾病中的应用: 回顾性分析。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1594
  • 作者列表:"Yang X","Zhai D","Zhang T","Zhang S
  • 发表时间:2020-06-22
Abstract

OBJECTIVE:Fine-needle aspiration cytology is the risk stratification tool for thyroid nodules, and ultrasound elastography is not routinely used for the differential diagnosis of thyroid cancer. The current study aimed to compare the diagnostic parameters of ultrasound elastography and fine-needle aspiration cytology, using surgical pathology as the reference standard. METHODS:In total, 205 patients with abnormal thyroid function test results underwent ultrasound-guided fine-needle aspiration cytology on the basis of the American College of Radiology Thyroid Imaging-Reporting and Data System classification and strain ultrasound elastography according to the ASTERIA criteria. Histopathological examination of the surgical specimens was performed according to the 2017 World Health Organization classification system. Moreover, a beneficial score analysis for each modality was conducted. RESULTS:Of 265 nodules, 212 measured ≥1 cm. The strain index value increased from benign to malignant nodules, and the presence of autoimmune thyroid diseases did not affect the results (p>0.05 for all categories). The sensitivities of histopathological examination, ultrasound elastography, and fine-needle aspiration cytology for detection of nodules measuring ≥1 cm were 1, 1, and 0.97, respectively. The working area for detecting nodule(s) in a single image was similar between strain ultrasound elastography and fine-needle aspiration cytology for highly and moderately suspicious nodules. However, for mildly suspicious, unsuspicious, and benign nodules, the working area for detecting nodule(s) in a single image was higher in strain ultrasound elastography than in fine-needle aspiration cytology. CONCLUSION:Strain ultrasound elastography for highly and moderately suspicious nodules facilitated the detection of mildly suspicious, unsuspicious, and benign nodules.

摘要

目的: 细针穿刺细胞学检查是甲状腺结节的危险分层工具,超声弹性成像并不是常规用于甲状腺癌的鉴别诊断疾病。本研究以手术病理为参考标准,比较超声弹性成像和细针穿刺细胞学的诊断参数。 方法: 共有205例甲状腺功能检测结果异常的患者,在美国放射学会甲状腺影像报告和数据系统分类的基础上,根据ASTERIA标准进行超声引导下细针穿刺细胞学检查,并进行应变超声弹性成像。根据2017世界卫生组织分类系统对手术标本进行组织病理学检查。此外,对每种模态进行了有益的评分分析。 结果: 265个结节中,212个测量 ≥ 1厘米,应变指数值由良性向恶性结节增加,自身免疫性甲状腺疾病的存在不影响结果 (所有类别p>0.05)。组织病理学检查、超声弹性成像和细针穿刺细胞学检查对检出结节 ≥ 1厘米的敏感性分别为1、1和0.97。对于高度和中度可疑结节,应变超声弹性成像和细针穿刺细胞学检查在单张图像中检测结节的工作区域相似。然而,对于轻度可疑、不可疑和良性结节,应变超声弹性成像在单张图像中检测结节的工作区域高于细针穿刺细胞学。 结论: 应变超声弹性成像对高度和中度可疑结节有助于发现轻度可疑、不可疑和良性结节。

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影响因子:1.61
发表时间:2020-01-01
来源期刊:Acta cytologica
DOI:10.1159/000496502
作者列表:["Nishino M","Krane JF"]

METHODS::Ancillary molecular testing has emerged as a promising way to refine the preoperative risk stratification of thyroid nodules with indeterminate fine needle aspiration (FNA) biopsy results. Commercially available molecular tests for thyroid FNAs include those that analyze samples for mutations and gene fusions, gene expression alterations, microRNA expression alterations, chromosomal copy number alterations, or a combination thereof. This review summarizes the performance characteristics of the most current iterations of three tests currently marketed for cytologically indeterminate thyroid nodules: ThyroSeq v3, ThyGeNEXT/ThyraMIR, and Afirma Gene Sequencing Classifier.

翻译标题与摘要 下载文献
影响因子:2.32
发表时间:2020-01-01
来源期刊:The Laryngoscope
DOI:10.1002/lary.27947
作者列表:["Ji T","Chen J","Mou J","Ni X","Guo Y","Zhang J","Wang S","Wang W","Zhang X","Tai J"]

METHODS:OBJECTIVES/HYPOTHESIS:The definition of large-volume pathologic N1 metastases has been changed in the 2017 version 2 of the National Comprehensive Cancer Network guidelines, leading to a controversy over the optimal surgical approach selection for patients with biopsy-proven papillary thyroid carcinoma (PTC). The aim of this study was to investigate the therapeutic efficacy of total thyroidectomy (TT) and thyroid lobectomy (TL) for these patients. STUDY DESIGN:Retrospective population-based database analysis. METHODS:A total of 906 consecutive PTC patients with pathologic N1 metastases (>5 involved nodes with metastases ≤5 mm in the largest dimension) were retrieved from the Surveillance, Epidemiology, and End Results database, and divided into two groups (≤2 mm, >2-5 mm) based on the size of the extent of disease. Overall survival (OS) was then compared between patients treated with TT and TL, followed by Cox proportional hazards regression analysis to explore multiple prognostic factors. RESULTS:OS favored TT compared with TL in patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension (P < .05). Cox analysis showed that the TL was not an independent factor associated with poorer OS than TT in these patients (P > .05). CONCLUSIONS:TT showed better survival than TL for patients with more than five involved nodes and metastases >2 to 5 mm in the largest dimension. For patients with more than five involved nodes and metastases ≤2 mm in the largest dimension, either TT or TL can be recommended because there was no difference in survival. LEVEL OF EVIDENCE:NA Laryngoscope, 130:269-273, 2020.

翻译标题与摘要 下载文献
影响因子:2.09
发表时间:2020-01-01
DOI:10.2174/1573399815666190417145440
作者列表:["Goes LG","da Luz Eltchechem C","Wouk J","Malfatti CRM","da Silva LA"]

METHODS:BACKGROUND:Obesity, diabetes mellitus may be related to the health, the relationship and the physiological capacity of the production of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4). OBJECTIVES:The main aims of this review are to describe the relationship between obesity, appetite, weight management, hormonal mechanisms of diabetes mellitus and hypothyroidism post-bariatric surgery. METHODOLOGY:An in-depth literature search was conducted to identify scientific studies, which analyzed the correlation between diabetes mellitus and hypothyroidism post-bariatric surgery. RESULTS:Bariatric surgery decreases hypothyroidism, reduces the need for pharmacological action (such as levothyroxine), controls the weight and body fat and increases the sensitivity to leptin and insulin. CONCLUSION:The reduction of the stomach and intestine by bariatric surgery is an evolutionary and beneficial action, because it may lead to a drastic decrease on numbers of conditions such as diabetes, obesity, hypothyroidism, and others. Thus, new studies should also focus on patients' post-operatory conditions, such as lifetime, regulation and functioning of organs after reduced nutrition, and consumption and delivery of nutrients to health maintenance.

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甲状腺疾病方向

主要分为内科治疗的甲状腺疾病和外科治疗的甲状腺疾病两大类。内科治疗的甲状腺疾病主要包括甲状腺功能亢进症和甲状腺炎症。外科治疗的甲状腺疾病包括甲状腺肿和甲状腺肿瘤。

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