Abstract:

Reasonable selection of thyroid nodule surgery range：United States and our guides interpretation        DAI Wen-jie，XU De-quan，YIN Yue. Department of Thyroid and Mammary Gland Cell Transplantation Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin150001, China
Corresponding author：DAI Wen-jie，E-mail：davidhmu@163.com
Abstract    Nodular thyroid disease is common in Department of Thyroid Surgery，and controversy continues to surround the management of nodular thyroid disease. The incidence of thyroid disease is increasing worldwide. The specialization of thyroid surgery combined with standard lymphadenectomy takes survival benefit for patients with differentiated thyroid carcinoma (DTC). American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer will be issued by American Thyroid Association (ATA) in 2015. The revised guidelines for the management of thyroid nodules and thyroid cancer includes recommendations regarding initial evaluation，clinical and ultrasound criteria for fine-needle aspiration (FNA) biopsy as well as use of molecular marks. Recommendations regarding the initial management of DTC include those relating to staging and risk assessment，surgical management，radioiodine remnant ablation，and TSH suppression therapy using levothyroxine. The revised guidelines make the basic principles for the treatment of thyroid nodules and DTC more scientific and accurate. It will provide important guidance for the future clinical practice.

Key words: thyroid nodules, differentiated thyroid cancer

摘要：

甲状腺结节是甲状腺外科最常见的疾病，其外科治疗一直存在争议。近年来甲状腺结节的发病率在全球范围内呈持续增长趋势。标准的甲状腺手术方式联合规范化的颈淋巴结清扫，对于改善病人的预后，具有至关重要的意义。2015年，美国甲状腺协会（ATA）将发布新版《ATA甲状腺结节和分化型甲状腺癌诊治指南》。该指南内容主要涉及良性甲状腺结节和分化型甲状腺癌（DTC）的初始超声、细针穿刺细胞学检查（FNA）及分子标记物的评估以及甲状腺癌的危险分层、外科治疗、131I治疗和TSH抑制治疗。新版ATA指南将甲状腺结节和DTC外科治疗的基本原则、概念更为科学化、精准化，为今后的临床实践提供了重要的指导作用。

关键词: 甲状腺结节, 分化型甲状腺癌