近年来，由于颈部超声和细针抽吸等多种诊断工具的广泛采用，甲状腺癌的发病率有所增加。最近，另一种可能在术前提供有关甲状腺肿瘤侵袭性、预后和复发率的重要信息的方法是分子检测。我们回顾了有关术前分子检测在 Bethesda V 和 Bethesda VI 甲状腺结节患者中的作用及其对最佳治疗策略选择的影响的文献。一些分子突变和改变与甲状腺癌及其生物学行为相关，例如 BRAF-V600E、RET 和 TERT 启动子。尽管许多研究已经分析了术前分子检测对不确定结节（Bethesda III 和 Bethesda IV）的价值，但目前的文献并未充分描述术前分子检测对 Bethesda V 和 Bethesda VI 甲状腺结节的影响。术前识别特定分子突变（例如 BRAFV600E 和 TERT 启动子突变）可能会通过改变诊断为更具侵袭性或碘抵抗亚型的甲状腺癌患者的手术方法和手术范围，为甲状腺癌患者提供更加个体化的治疗.甲状腺癌的特点是多种基因突变和改变，因此，恶性结节的术前分子检测对于外科医生来说可能是一个非常有用的工具，使他们能够为每位患者决定最合适的手术方法。© 2024。作者获得希腊内分泌学会的独家许可。

The incidence of thyroid cancer has increased over recent years due to the fact that several diagnostic tools, such as neck ultrasound and fine-needle aspiration, are being ever more widely adopted. Lately, another modality which might provide significant information preoperatively on the aggressiveness of a thyroid tumor, its prognosis, and its recurrence rate is molecular testing. We reviewed the literature with regard to the role of preoperative molecular testing in patients with Bethesda V and Bethesda VI thyroid nodules and its impact on choice of the optimal treatment strategy. Several molecular mutations and alterations are associated with thyroid cancer and its biological behavior, such as BRAF-V600E, RET, and TERT promoter. Although the value of preoperative molecular testing for indeterminate nodules (Bethesda III and Bethesda IV) have been analyzed in numerous studies, the impact of preoperative molecular testing on Bethesda V and Bethesda VI thyroid nodules is not adequately described in the current literature. The preoperative recognition of specific molecular mutations, such as BRAFV600E and TERT promoter mutation, might provide more individualized management for thyroid cancer patients by altering the surgical approach and the extent of surgery for patients diagnosed with a more aggressive or iodine-resistant subtype of thyroid cancer.Thyroid cancer is characterized by multiple genetic mutations and alterations and, as a result, preoperative molecular testing of malignant nodules could be a very useful tool for surgeons, enabling them to decide on the most appropriate surgical approach for each patient.© 2024. The Author(s), under exclusive licence to Hellenic Endocrine Society.