Diagnostyka i leczenie raka tarczycy

Abstract

These recommendations are created by the group of delegates of the National Societies, which declare their willingness to participate in the preparation of the revised version of the Polish Guidelines. The members of the Working Group have been chosen from the specialists involved in medical care of patients with thyroid carcinoma. Directly before the preparation of the Polish national recommendations the American Thyroid Association (ATA) published its own guidelines together with a wide comment fulfilling evidence-based medicine (EBM) criteria. ATA Guidelines are consistent with National Comprehensive Cancer Network (NCCN) Recommendation. According to the members of the Working Group, it is necessary to adapt them to both the specific Polish epidemiological situation as well as to the rules referring to the Polish health system. Therefore, the Polish recommendations constitute a consensus of the experts' group, based on ATA information. The experts analysed previous Polish Guidelines, published in 2010, and other available Diagnostics and Treatment of Thyroid Carcinoma Barbara Jarząb et al.

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

“…In the case of cytological group 4 diagnostic operations (usually subtotal thyroidectomy) are recommended to be considered. However, in the case of cytological group 5 a diagnostic operationtotal or subtotal thyroidectomy -is recommended [8] . Unnecessary operations (benign histology) occur most frequently in patients with cytological groups 3 and 4 because of the low prevalence of TC in these groups (10-25% in group 3 and 15-30% in group 4) [11].…”

“…Patients were qualified for biopsy from the Endocrinology Outpatient Clinic in Holycross Cancer Centre, Kielce, Poland according to "AACE/AME/ETA medical guidelines for clinical practice and management of thyroid nodules" [7] and according to "Diagnosis and treatment of thyroid cancer -Polish guidelines" [8]. The smears were evaluated according to Bethesda Thyroid Cytology Classification (Bethesda system).…”

Analiza znaczenia klinicznego niejednoznacznych wyników biopsji tarczycy ze szczególnym uwzględnieniem kategorii ZPBN na podstawie 5 lat stosowania nowej klasyfikacji rozpoznań cytologicznych

“…The goal of that modification was to delineate FL with low malignancy risk, in which it is justified to perform repeat FNA within 6 to 18 months in order to obtain more precise diagnosis. That additional diagnostic category was meant to be formulated mainly when there were features of both benign lesion and follicular neoplasm coexisting in a smear, and in that way it was adopted into Polish recommendations for diagnostics of the thyroid nodules [6]. However, the definition of FLUS adopted by the NCI is wider.…”

“…Thus, the attempt to improve classification of cytological results undertaken by the National Cancer Institute (NCI) in 2008 was accepted with much hope by centres focused on diagnostics of the thyroid nodules [4][5]. In Poland the new classification of thyroid biopsy results, based on NCI proposal, has been in full operation for five years [6]. The classification introduced the new subgroup of the results within ISC "follicular lesion of undetermined significance" (FLUS).…”

“…It is also unclear whether implementation of the new FLUS category does not significantly affect the malignancy risk related to other ISC categories (SFN and SM). That risk was assumed for SFN category as 5-20% and for SM category -30-50%, according to Polish Recommendations [6]. Thus, the aim of the paper was to determine the actual risk of malignancy in the case of FLUS diagnosis and to compare it to the cancer risk in cases of SFN and SM, as assessed by analysis of repeat FNA and postoperative histopathological examinations.…”