图片来源:www.veer.com近期也有研究认为,当肿瘤直径达到20 mm再手术对患者预后也没有影响。但该研究人数有限,结论缺乏更多的证据支持。综合考虑,仍然建议将肿瘤直径增长≥3 mm或发现临床淋巴结转移作为积极监测和手术治疗的分界线。参考文献1.Iwao Sugitani, et al. Indications and Strategy for Active Surveillance of Adult Low-Risk Papillary Thyroid Microcarcinoma: Consensus Statements from the Japan Association of Endocrine Surgery Task Force on Management for Papillary Thyroid Microcarcinoma. Thyroid, 2021, 31(2): 183-192.2.褚晓秋, 等. 甲状腺乳头状微小癌的积极监测:实施与困惑. 中华内分泌代谢杂志,2019,35 (4): 269-275.3.Allen S Ho, et al. Expanded Parameters in Active Surveillance for Low-risk Papillary Thyroid Carcinoma: A Nonrandomized Controlled Trial. JAMA Oncol. 2022.