甲状腺结节和分化型甲状腺癌诊治指南(第二版)

中华内分泌代谢杂志2023年3月第39卷第3期Chin J Endocrinol Metab,Maeh2023,Vol.39,No.3·181··指南与共识·甲状腺结节和分化型甲状腺癌诊治指南(第二版)中华医学会内分泌学分会中华医学会外科学分会甲状腺及代谢外科学组中国抗癌协会头颈肿瘤专业委员会中华医学会核医学分会中国抗癌协会甲状腺癌专业委员会中国医师协会外科医师分会甲状腺外科医师委员会中华医学会超声医学分会【提要】中国《甲状腺结节和分化型甲状腺癌诊治指南》（第二版）是在第一版(2012年版)的基础上进行的修订。参与第二版指南修订的国家级学会由4个增加为7个，内分泌科、甲状腺外科、肿瘤科、核医学科、超声医学科和病理科专家都参与了本指南的编撰，增加了指南的权威性。指南采用最佳的临床证据并综合专家意见给出了117条推荐，内容全面而系统。明确了甲状腺结节的筛查人群，增加了超声鉴别甲状腺结节良恶性的中国标准，提出了超声引导下的细针抽吸活检和粗针活检的适应证，对分化型甲状腺癌术前评估、术式、术后分期、随访、I治疗、促甲状腺激素抑制治疗、靶向药物治疗以及新兴的治疗方法给予了比较全面和客观的修订。第二版指南将为进一步指导和规范甲状腺结节和甲状腺癌的诊断治疗发挥积极的推动作用。【关键词】甲状腺结节；分化型甲状腺癌；诊治指南D0I:10.3760/cma.i.cm311282-20221023-00589Guidelines for the diagnosis and management of thyroid nodules and differentiated thyroid cancer Secondedition)Chinese Society of Endocrinology;Thyroid and Metabolism Surgery Group of the Chinese Society of Surgery;ChinaAnti-Cancer Association,Chinese Association of Head and Neck Oncology;Chinese Society of Nuclear Medicine;ChinaAnti-Cancer Association,Chinese Association of Thyroid Oncology;Chinese Thyroid Association,Chinese Collage ofSurgeons,Chinese Medical Doctor Association;Chinese Society of Ultrasound in Medicine[Summary The Chinese guidelines for the diagnosis and management of thyroid nodules and differentiatedthyroid cancer(Second edition)were revised on the basis of the 2012 edition.The number of national societiesinvolved in the revision increased from four to seven,endocrinology,thyroid surgery,oncology,nuclear medicine,ultrasound,and pathology,which enhanced the authority of the guidelines.The guideline is comprehensive andsystematic with 117 recommendations based on the best clinical evidence and expert opinion.The guideline clarifiesthe population clusters for thyroid nodules screening,draws up the Chinese standard of ultrasound for differentiatingbenign and malignant thyroid nodules and proposes the indications of ultrasound-guided fine-needle aspirations biopsyand core needle biopsy.It effectuates a more comprehensive and objective revision for preoperative evaluation,surgicalprocedures,postoperative staging,follow-up strategyI therapy,thyroid stimulating hormone suppressive therapy,targeted medication,and emerging therapeutic methods for differentiated thyroid cancer.The edition will be an activeimpetus in improving the diagnosis and therapeutic landscape of thyroid nodules and differentiated thyroid cancerin China.Key words Thyroid nodules;Differentiated thyroid cancer;GuidelinesD0I:10.3760/cma.j.cm311282-20221023-00589