2015 年美国甲状腺协会（American Thyroid Association，ATA）颁布的《成人甲状腺结节和分化型甲状腺癌的管理指南》Bryan R. Haugen MDC, Erik K, et al. 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 [EB/OL].
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
University of Colorado School of Medicine, Aurora, Colorado.
Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.
The Mayo Clinic, Rochester, Minnesota.
Boston Medical Center, Boston, Massachusetts.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
The University of Siena, Siena, Italy.
Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
University Health Network, University of Toronto, Toronto, Ontario, Canada.
Institute Gustave Roussy and University Paris Sud, Villejuif, France.
Oregon Health and Science University, Portland, Oregon.
University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Duke University School of Medicine, Durham, North Carolina.
University of Cincinnati Medical Center, Cincinnati, Ohio.
Memorial Sloan Kettering Cancer Center, New York, New York.
MedStar Washington Hospital Center, Washington, DC.
Authors are listed in alphabetical order and were appointed by ATA to independently formulate the content of this manuscript. None of
the scientific or medical content of the manuscript was dictated by the ATA.