2023年版《Bethesda甲状腺细胞学分类诊断系统》更新要点及解读  

Key updates and interpretation of the 2023 edition of the Bethesda System for Reporting Thyroid Cytopathology

作　　者：张福荣 赵萩阳 黄韬[1] ZHANG Fu-rong;ZHAO Qiu-yang;HUANG Tao(Department of Breast and Thyroid Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院甲状腺乳腺外科,湖北武汉430022

出　　处：《中国实用外科杂志》2024年第2期139-143,共5页Chinese Journal of Practical Surgery

基　　金：湖北省重点研发计划项目(No.2021BCA142)。

摘　　要：2023年版《Bethesda甲状腺细胞学分类诊断系统》与2022年世界卫生组织甲状腺肿瘤分类相对应。相比于2010年和2017年两个版本,2023年版《Bethesda甲状腺细胞学分类诊断系统》在诊断分级、推荐管理方式、恶性肿瘤风险等方面均有更新并增加分子检测内容。不同的分子事件推动甲状腺癌的去分化演进进程并证实了分子检测的意义。随着分子检测对甲状腺癌诊断效能的提高,其在甲状腺癌诊治方面的应用范围逐渐扩大,甚至部分应用于确定术式。但目前无论单基因或是多基因分子检测均存在其不足,故而分子检测是否确实可以广泛应用于临床实践来决策手术方式尚有待进一步研究。The 2023 edition of Bethesda System for Reporting Thyroid Cytopathology corresponds to the 2022 World Health Organization classification of thyroid tumors.In comparison to the 2010 and 2017 versions,significant updates in terms of diagnostic grading,recommended management approaches,and the assessment for risk of malignancy,as well as supplement of molecular testing have been made in the 2023 edition of Bethesda System for Reporting Thyroid Cytopathology.Distinct molecular events driving the dedifferentiation process in thyroid cancer have been identified,affirming the significance of molecular testing.As molecular testing continues to enhance the diagnostic efficacy of thyroid cancer,its application in the diagnosis and treatment of thyroid cancer is gradually expanding,with some instances even influencing surgical decision-making.However,both single-gene and multi-gene molecular testing still have limitations.Therefore,the widespread applicability of molecular testing in clinical practice to guide surgical decisions requires further research.

关 键 词：甲状腺癌 BETHESDA 分型 分子检测 手术方式 

分 类 号：R6[医药卫生—外科学]