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首页> 美国卫生研究院文献>Thyroid >2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer
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2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

机译：2015年美国甲状腺协会针对成年甲状腺结节和分化型甲状腺癌患者的管理指南：美国甲状腺协会指南工作组针对甲状腺结节和分化型甲状腺癌

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>Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.>Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members.>Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research.>Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patients with these disorders.
机译：>背景：甲状腺结节是常见的临床问题，分化型甲状腺癌正变得越来越普遍。自2009年修订美国甲状腺协会（ATA）处理这些疾病的指南以来，该领域已取得了重大的科学进展。这些指南的目的是向临床医生，患者，研究人员和卫生政策制定者提供有关甲状腺结节和分化型甲状腺癌的诊断和管理的已发表证据的信息。>方法：这些准则基于准则的先前版本，利益相关者的意见以及工作组成员的意见。对工作组的成员进行了知识综合方法的教育，包括电子数据库搜索，相关引文的审查和选择以及对选定研究的严格评估。已发表的有关成年人的英语文章可以被纳入。美国医师学会指南评分系统用于证据的严格评估和治疗干预建议的分级强度。我们开发了一种格式类似的系统来评估此类研究的质量和所产生的建议。指南小组完全独立于ATA。定期更新，管理指南工作队成员的竞争利益，并将其传达给ATA和工作队成员。>结果：经修订的甲状腺结节管理指南包括有关初始评估，临床和超声检查的建议细针穿刺活检的标准，细针穿刺活检结果的解释，分子标志物的使用以及甲状腺良性结节的管理。有关甲状腺癌初始治疗的建议包括与筛查甲状腺癌，分期和风险评估，外科手术治疗，放射性碘残留消融和治疗以及使用左甲状腺素抑制甲状腺素的治疗有关的建议。与分化型甲状腺癌的长期治疗有关的建议包括与通过影像学检查和血清甲状腺球蛋白监测复发性疾病，甲状腺激素治疗，复发和转移性疾病的治疗，临床试验和靶向治疗的考虑以及未来的方向有关的建议研究。>结论：我们已经开发了基于证据的建议，可为甲状腺结节和分化型甲状腺癌的治疗提供临床决策依据。我们认为，它们代表了针对这些疾病患者的当代最佳护理。

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