2009 ATA 甲状腺结节和分化型甲状腺癌指南修订版
2009ATA Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer
Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becomingincreasingly prevalent. Since the publication of the American Thyroid Association’s guidelines for the managementof these disorders was published in 2006, a large amount of new information has become available,prompting a revision of the guidelines.Methods: Relevant articles through December 2008 were reviewed by the task force and categorized by topic andlevel of evidence according to a modified schema used by the United States Preventative Services Task Force.Results: The revised guidelines for the management of thyroid nodules include recommendations regardinginitial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needleaspiration biopsy results, and management of benign thyroid nodules. Recommendations regarding the initialmanagement of thyroid cancer include those relating to optimal surgical management, radioiodine remnantablation, and suppression therapy using levothyroxine. Recommendations related to long-term management ofdifferentiated thyroid cancer include those related to surveillance for recurrent disease using ultrasound andserum thyroglobulin as well as those related to management of recurrent and metastatic disease.Conclusions: We created evidence-based recommendations in response to our appointment as an independenttask force by the American Thyroid Association to assist in the clinical management of patients with thyroidnodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patientswith these disorders.