甲状腺结节在普通人群中的患病率接近 25%，是一种常见现象。其患病率因年龄、性别等人口统计数据以及是否存在危险因素而有很大差异。本文全面概述了甲状腺结节的患病率、风险分层和当前的管理策略，特别关注过去 10 年来诊断和治疗方案的变化。几种基于超声检查的分层系统（例如甲状腺成像报告和数据系统（TIRADS））可能有助于预测结节的恶性风险，在许多情况下可能消除活检的需要。然而，大的或可疑的结节需要在细针抽吸活检后进行细胞学评估以进行准确分类。在细胞学产生不确定结果的情况下，分子检测等其他工具可以帮助指导管理计划。手术不再是有症状或恶性结节的唯一治疗方法：积极监测或局部消融治疗可能对适当选择的患者有益。为了加强临床医生与患者的互动以及有关诊断选择的讨论，开发了共享决策工具。基于风险的个性化方案可促进高质量护理，同时最大限度地减少成本和不必要的测试。© 2024。Springer Nature Limited。

Thyroid nodules, with a prevalence of almost 25% in the general population, are a common occurrence. Their prevalence varies considerably depending on demographics such as age and sex as well as the presence of risk factors. This article provides a comprehensive overview of the prevalence, risk stratification and current management strategies for thyroid nodules, with a particular focus on changes in diagnostic and therapeutic protocols that have occurred over the past 10 years. Several sonography-based stratification systems (such as Thyroid Imaging Reporting and Data Systems (TIRADS)) might help to predict the malignancy risk of nodules, potentially eliminating the need for biopsy in many instances. However, large or suspicious nodules necessitate cytological evaluation following fine-needle aspiration biopsy for accurate classification. In the case of cytology yielding indeterminate results, additional tools, such as molecular testing, can assist in guiding the management plan. Surgery is no longer the only treatment for symptomatic or malignant nodules: active surveillance or local ablative treatments might be beneficial for appropriately selected patients. To enhance clinician-patient interactions and discussions about diagnostic options, shared decision-making tools have been developed. A personalized, risk-based protocol promotes high-quality care while minimizing costs and unnecessary testing.© 2024. Springer Nature Limited.