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经皮微波消融治疗甲状腺结节:对甲状腺功能及抗体的影响

Percutaneous microwave ablation of thyroid nodules: effects on thyroid function and antibodies.

作者信息

Heck Kristina, Happel Christian, Grünwald Frank, Korkusuz Huedayi

机构信息

Department of Nuclear Medicine, University Hospital, Frankfurt am Main, and German Centre for Thermoablation of Thyroid Nodules , Frankfurt am Main , Germany.

出版信息

Int J Hyperthermia. 2015;31(5):560-7. doi: 10.3109/02656736.2015.1032371. Epub 2015 Apr 29.

Abstract

PURPOSE

Microwave ablation (MWA) is a new minimally invasive method for thermal ablation of benign thyroid nodules with promising results. The aim of this study was to investigate whether MWA has an impact on thyroid function.

MATERIALS AND METHODS

Thirty patients with a total of 34 benign thyroid nodules underwent MWA between January 2013 and July 2014. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and additionally antibodies against Tg (anti-Tg), thyrotropin receptors (TRAb) and thyroid peroxidase (anti-TPO) were measured at enrolment, 24 h after MWA, as well as at the 3-month and 6-month follow-up. Moreover, the nodule volume was evaluated to determine effectiveness.

RESULTS

Serum TSH, T4, T3 and Tg levels did not change significantly at the 3-month or 6-month follow-up (p > 0.05); thyroid function was not affected by MWA. Antibody levels did not change significantly either; however, two patients developed antibodies after treatment. A volume reduction of 51.4% or 7.85 mL could be demonstrated after 3 months and a reduction of 55.8% or 14.0 mL after 6 months. Slight complications such as mild pain during the ablation or superficial haematomas emerged. The development of Graves' disease and mild Horner's syndrome were observed as more severe side effects.

CONCLUSIONS

The data suggest MWA as an alternative for the treatment of benign thyroid nodules. While first results for preservation of thyroid function are positive, further measurements of laboratory data and especially antibodies are necessary.

摘要

目的

微波消融(MWA)是一种用于良性甲状腺结节热消融的新型微创方法,效果良好。本研究旨在探讨MWA是否会对甲状腺功能产生影响。

材料与方法

2013年1月至2014年7月期间,30例患者共34个良性甲状腺结节接受了MWA治疗。在入组时、MWA治疗后24小时以及3个月和6个月随访时,测定血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、甲状腺球蛋白(Tg),另外还测定了抗Tg抗体(抗Tg)、促甲状腺激素受体抗体(TRAb)和甲状腺过氧化物酶抗体(抗TPO)。此外,评估结节体积以确定治疗效果。

结果

在3个月或6个月随访时,血清TSH、T4、T3和Tg水平无显著变化(p>0.05);MWA未影响甲状腺功能。抗体水平也无显著变化;然而,有两名患者在治疗后产生了抗体。3个月后结节体积缩小51.4%或7.85 mL,6个月后缩小55.8%或14.0 mL。出现了轻微并发症,如消融过程中的轻度疼痛或皮下血肿。观察到更严重的副作用包括格雷夫斯病和轻度霍纳综合征的发生。

结论

数据表明MWA可作为治疗良性甲状腺结节的一种替代方法。虽然在保留甲状腺功能方面的初步结果是积极的,但仍需要进一步检测实验室数据,尤其是抗体。

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