Diao Zongli, Liu Xu, Qian Linxue, Liu Jing, Liu Sha, Liu Wenhu
a Department of Nephrology , Beijing Friendship Hospital, Capital Medical University , Beijing , China ;
b Department of Ultrasound , Beijing Friendship Hospital, Capital Medical University , Beijing , China.
Int J Hyperthermia. 2016 Sep;32(6):614-22. doi: 10.1080/02656736.2016.1194485. Epub 2016 Jun 22.
Microwave ablation (MWA) can be used to treat severe secondary hyperparathyroidism; however, its efficacy and the predictor of its efficacy are unclear. In this retrospective study we determined the predictor of efficacy of MWA and compared the efficacy of MWA and parathyroidectomy.
Patients with severe secondary hyperparathyroidism who had received MWA or parathyroidectomy were enrolled in the study. Participants with MWA were divided into response and no response groups based on efficacy. Possible predictors were analysed using logistic regression to determine efficacy predictors. The participants were divided into MWA and parathyroidectomy groups, and the efficacy (including rates of achieving recommended goals for intact parathyroid hormone (iPTH), calcium, and phosphorus levels) were compared between the two groups.
Thirty-one participants were enrolled for predictor analysis. Only baseline iPTH level predicted efficacy (OR 0.997, P = 0.018). The optimal threshold value of iPTH for predicting efficacy was 1493.5 pg/mL. To compare efficacy, 30 patients were enrolled in MWA (18/30) and parathyroidectomy (12/30) groups. The rates of achieving recommended goals for iPTH levels varied between 0 and 60%; a significant difference was found between the groups at 5 months (P = 0.01). However, in the parathyroidectomy group, the iPTH level and rate of iPTH <124 pg/mL (lower limit of target range) were significantly lower than in the MWA group after treatment (40-75% versus 0-16.7%).
Baseline iPTH level is a good predictor of MWA efficacy for severe secondary hyperparathyroidism; parathyroidectomy is more effective for severe secondary hyperparathyroidism than MWA.
微波消融（MWA）可用于治疗重度继发性甲状旁腺功能亢进；然而，其疗效及疗效预测因素尚不清楚。在这项回顾性研究中，我们确定了MWA疗效的预测因素，并比较了MWA与甲状旁腺切除术的疗效。
纳入接受MWA或甲状旁腺切除术的重度继发性甲状旁腺功能亢进患者。根据疗效将接受MWA的参与者分为反应组和无反应组。使用逻辑回归分析可能的预测因素以确定疗效预测指标。将参与者分为MWA组和甲状旁腺切除组，比较两组的疗效（包括达到完整甲状旁腺激素（iPTH）、钙和磷水平推荐目标的比率）。
31名参与者纳入预测因素分析。仅基线iPTH水平可预测疗效（OR 0.997，P = 0.018）。预测疗效的iPTH最佳阈值为1493.5 pg/mL。为比较疗效，30例患者纳入MWA组（18/30）和甲状旁腺切除组（12/30）。iPTH水平达到推荐目标的比率在0至60%之间；两组在5个月时存在显著差异（P = 0.01）。然而，在甲状旁腺切除组中，治疗后iPTH水平及iPTH<124 pg/mL（目标范围下限）的比率显著低于MWA组（40 - 75%对0 - 16.7%）。
基线iPTH水平是重度继发性甲状旁腺功能亢进MWA疗效的良好预测指标；甲状旁腺切除术治疗重度继发性甲状旁腺功能亢进比MWA更有效。
