1.Systematic interpretation of the 2025 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer
Yanjun SU ; Ying PENG ; Zhizhong DONG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):867-878
Thyroid cancer has become one of the fastest-growing malignancies in recent years,with a significant improvement in the 5-year relative survival rate among Chinese patients.Accurate diagnosis,standardized treatment,and effective follow-up are essential to improve clinical outcomes,while the promotion and implementation of clinical guidelines are critical for achieving standardized and homogeneous management.In 2022,the China Anti-Cancer Association(CACA)released the 2022 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer,which systematically applied the concept of multidisciplinary integrated management to the entire care continuum of thyroid cancer,reflecting both Chinese characteristics and local experience.Building upon this,the 2025 edition of the guidelines was updated and revised based on the latest evidence and clinical practices.This article provides a systematic interpretation of the 2025 CACA guidelines,focusing on the diagnosis,treatment,and follow-up of thyroid cancer,with the aim of offering practical guidance for clinicians and promoting standardized,integrated management of thyroid cancer in clinical practice.
2.Assessment of the quality of diagnosis and surgical procedure coding for thyroid cancer on the front page of medical records in a single center
Wen LIU ; Dewei RAO ; Zhizhong DONG ; Miao YANG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):921-929
Background and Aims:As a core data source in the development of medical informatization,the front page of inpatient medical records plays a crucial role in determining the usability of research data and the scientific quality of clinical decision-making.Given the relatively standardized diagnostic and treatment protocols for thyroid malignancies,this disease serves as a representative model for evaluating the data quality of medical record front sheets.This study aimed to systematically assess the accuracy of diagnostic and surgical procedure coding for thyroid malignancies on the medical record front page,identify existing problems,and explore strategies for improvement and the potential for future application in clinical research.Methods:A total of 3 361 patients who underwent initial surgical treatment and were pathologically confirmed with thyroid cancer at the Department of Thyroid Surgery,the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2020 were retrospectively included.Postoperative pathology reports and surgical records were used as reference standards to evaluate the accuracy of primary and secondary diagnosis codes,as well as primary and secondary surgical procedure codes on the medical record front page.Results:The accuracy rate of primary diagnosis coding reached 98.8%.However,among 1 368 patients with cervical lymph node metastasis,only 31.2%had correctly recorded secondary diagnosis codes and metastatic sites,with an omission rate as high as 67.8%.The overall accuracy rate for primary surgical procedure coding was 90.4%,with thyroid lobectomy(TL)and total thyroidectomy(TT)coding accuracies of 85.5%and 96.0%,respectively.Among the coding errors,70.0%involved TL procedures being incorrectly coded as TT.Secondary surgical procedure codes—mainly for lymph node dissection—were highly inconsistent,with up to 14 different coding types,reflecting a lack of standardization and unified input criteria.Notably,the error rate for primary surgical coding in 2020 increased significantly compared with the previous two years,suggesting subjectivity and variability in manual data entry.Conclusion:This study highlights major accuracy deficiencies in surgical procedure coding for thyroid malignancies on the medical record front page,which may compromise the scientific validity of real-world data.Going forward,leveraging artificial intelligence technologies to support structured documentation and automated coding,alongside establishing a proactive quality control system through multidisciplinary collaboration,may significantly improve data accuracy.These efforts are essential for strengthening data foundations for precision treatment,performance evaluation,insurance payment,and clinical research on thyroid cancer.
3.Assessment of the quality of diagnosis and surgical procedure coding for thyroid cancer on the front page of medical records in a single center
Wen LIU ; Dewei RAO ; Zhizhong DONG ; Miao YANG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):921-929
Background and Aims:As a core data source in the development of medical informatization,the front page of inpatient medical records plays a crucial role in determining the usability of research data and the scientific quality of clinical decision-making.Given the relatively standardized diagnostic and treatment protocols for thyroid malignancies,this disease serves as a representative model for evaluating the data quality of medical record front sheets.This study aimed to systematically assess the accuracy of diagnostic and surgical procedure coding for thyroid malignancies on the medical record front page,identify existing problems,and explore strategies for improvement and the potential for future application in clinical research.Methods:A total of 3 361 patients who underwent initial surgical treatment and were pathologically confirmed with thyroid cancer at the Department of Thyroid Surgery,the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2020 were retrospectively included.Postoperative pathology reports and surgical records were used as reference standards to evaluate the accuracy of primary and secondary diagnosis codes,as well as primary and secondary surgical procedure codes on the medical record front page.Results:The accuracy rate of primary diagnosis coding reached 98.8%.However,among 1 368 patients with cervical lymph node metastasis,only 31.2%had correctly recorded secondary diagnosis codes and metastatic sites,with an omission rate as high as 67.8%.The overall accuracy rate for primary surgical procedure coding was 90.4%,with thyroid lobectomy(TL)and total thyroidectomy(TT)coding accuracies of 85.5%and 96.0%,respectively.Among the coding errors,70.0%involved TL procedures being incorrectly coded as TT.Secondary surgical procedure codes—mainly for lymph node dissection—were highly inconsistent,with up to 14 different coding types,reflecting a lack of standardization and unified input criteria.Notably,the error rate for primary surgical coding in 2020 increased significantly compared with the previous two years,suggesting subjectivity and variability in manual data entry.Conclusion:This study highlights major accuracy deficiencies in surgical procedure coding for thyroid malignancies on the medical record front page,which may compromise the scientific validity of real-world data.Going forward,leveraging artificial intelligence technologies to support structured documentation and automated coding,alongside establishing a proactive quality control system through multidisciplinary collaboration,may significantly improve data accuracy.These efforts are essential for strengthening data foundations for precision treatment,performance evaluation,insurance payment,and clinical research on thyroid cancer.
4.Interpretation of the update points of China CACA Thyroid Cancer Guidelines (2025 edition) from a surgical perspective
Ying PENG ; Yanjun SU ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(1):8-13
Based on the latest clinical research results and evidence-based medicine evidence, CACA Guidelines for the Diagnosis and Treatment of Thyroid Cancer (2025 edition) , on account of the 2022 edition of CACA Guidelines, integrated personalized diagnosis and treatment strategies, promoted the development of multi-disciplinary collaboration, and strive to provide more comprehensive and accurate guidance for tumor diagnosis and treatment. While surgical resection is still the key treatment to improve the prognosis of the vast majority of patients with thyroid cancer (TC) . However, the scope of initial surgery should vary from person to person, and developing a more standardized surgical strategy and a more reasonable individualized treatment plan for TC patients is the key to achieving the optimal treatment effect. This paper will interpret the key points of updating the 2025 CACA guidelines from a surgical perspective, and explore the important value of surgical treatment strategies that conform to China’s national conditions in the entire management of TC diagnosis and treatment.
5.Application of carbon nanoparticles in thyroid cancer surgery: current status and considerations
Dewei RAO ; Zhizhong DONG ; Miao YANG ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(4):617-622
Surgery is the most important and effective way to treat thyroid cancer. How to reduce surgical complications while completely treating tumor has always been the focus and difficulty of thyroid surgery. Carbon nanoparticles suspension injection is the third generation lymph node tracer, with strong staining specificity, rapid development, long staining time, simple use, harmless to human body and other characteristics, showing unique clinical value in lymph node tracing, parathyroid identification and protection. However, the application of carbon nanoparticles in thyroid surgery is still controversial. After literature review, the authors address the clinical application of carbon nanoparticles in thyroid cancer surgery.
6.Systematic interpretation of the 2025 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer
Yanjun SU ; Ying PENG ; Zhizhong DONG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):867-878
Thyroid cancer has become one of the fastest-growing malignancies in recent years,with a significant improvement in the 5-year relative survival rate among Chinese patients.Accurate diagnosis,standardized treatment,and effective follow-up are essential to improve clinical outcomes,while the promotion and implementation of clinical guidelines are critical for achieving standardized and homogeneous management.In 2022,the China Anti-Cancer Association(CACA)released the 2022 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer,which systematically applied the concept of multidisciplinary integrated management to the entire care continuum of thyroid cancer,reflecting both Chinese characteristics and local experience.Building upon this,the 2025 edition of the guidelines was updated and revised based on the latest evidence and clinical practices.This article provides a systematic interpretation of the 2025 CACA guidelines,focusing on the diagnosis,treatment,and follow-up of thyroid cancer,with the aim of offering practical guidance for clinicians and promoting standardized,integrated management of thyroid cancer in clinical practice.
7.Interpretation of the update points of China CACA Thyroid Cancer Guidelines (2025 edition) from a surgical perspective
Ying PENG ; Yanjun SU ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(1):8-13
Based on the latest clinical research results and evidence-based medicine evidence, CACA Guidelines for the Diagnosis and Treatment of Thyroid Cancer (2025 edition) , on account of the 2022 edition of CACA Guidelines, integrated personalized diagnosis and treatment strategies, promoted the development of multi-disciplinary collaboration, and strive to provide more comprehensive and accurate guidance for tumor diagnosis and treatment. While surgical resection is still the key treatment to improve the prognosis of the vast majority of patients with thyroid cancer (TC) . However, the scope of initial surgery should vary from person to person, and developing a more standardized surgical strategy and a more reasonable individualized treatment plan for TC patients is the key to achieving the optimal treatment effect. This paper will interpret the key points of updating the 2025 CACA guidelines from a surgical perspective, and explore the important value of surgical treatment strategies that conform to China’s national conditions in the entire management of TC diagnosis and treatment.
8.Application of carbon nanoparticles in thyroid cancer surgery: current status and considerations
Dewei RAO ; Zhizhong DONG ; Miao YANG ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(4):617-622
Surgery is the most important and effective way to treat thyroid cancer. How to reduce surgical complications while completely treating tumor has always been the focus and difficulty of thyroid surgery. Carbon nanoparticles suspension injection is the third generation lymph node tracer, with strong staining specificity, rapid development, long staining time, simple use, harmless to human body and other characteristics, showing unique clinical value in lymph node tracing, parathyroid identification and protection. However, the application of carbon nanoparticles in thyroid surgery is still controversial. After literature review, the authors address the clinical application of carbon nanoparticles in thyroid cancer surgery.
9.Comparison of New and Old Versions of Guidelines for Diagnosis and Treatment of Thyroid Nodules and Differentiated Thyroid Carcinoma in China from A Surgical Perspective
Tingting YANG ; Yanjun SU ; Ruochuan CHENG
Cancer Research on Prevention and Treatment 2024;51(1):16-21
The set of guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer (the second edition) was published in 2023 in China. Based on the first (2012) edition, the current set was revised jointly by nearly 100 experts in endocrinology, thyroid surgery, oncology, nuclear medicine, ultrasound medicine, and pathology from seven national societies for one year. The new version of the guideline is still divided into two parts, namely, thyroid nodules and differentiated thyroid cancer. The writing mode of asking clinical questions, explaining and giving recommendations is adopted, and a total of 117 recommendations are provided. This article aims to compare the variations in the differentiation of benign and malignant thyroid nodules and surgical treatment of differentiated thyroid cancer between the new and old versions from the perspective of surgery. The author's own understanding and experiences are also discussed.
10.The regulatory mechanism and research status of deiodinating isozymes at the cellular level of thyroid hormone levels
Xin HE ; Ying PENG ; Jing PENG ; Shiqi WANG ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2024;18(1):138-140
As color doppler ultrasound listed as the thyroid to regular physical examination project, the positive detection rate of benign and malignant thyroid diseases has increased year by year. The population of patients after thyroid surgery is getting larger and larger, however, the research on how to replace the absent thyroid with exogenous thyroid hormone is not perfect. As the switch of thyroid hormone activation and deactivation, deiodinase plays an important role in maintaining the internal environment of human body. The expression of these enzymes will change with the different needs of each organ in the individual. In the past, many authors have made a detailed description of deiodinase in basic medicine, but the principle of action in clinical aspects is relatively lacking. In this paper, the mechanism of deiodinase was reviewed through literature reading, to explore the basic principle of deiodinase in exogenous thyroid hormone supplementation after thyroid surgery.

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