Sui Wei Fan, Li Jian Yun, Fu Jian Hua
Department of Interventional Radiology, The Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, 212002, China.
Oncotarget. 2017 May 17;8(47):83225-83236. doi: 10.18632/oncotarget.17928. eCollection 2017 Oct 10.
To evaluate percutaneous laser ablation in treating benign thyroid nodules, we conducted a meta-analysis based on summarizing existing researches.
A literature search for clinical trial was performed in PubMed, Cochrane Library and Excerpt Medica Database. The qualities of included studies were evaluated. We calculated the indexes with mean difference. Heterogeneity and publication bias were tested and explored. We performed subgroup analyses and sensitivity analysis further.
A total of 19 researches and 2137 patients were included in this meta-analysis. The pooled estimates of nodule volume were statistically significant after percutaneous laser ablation for 1 month, 3 month, 6month, 12month, 24month and 36month( < 0.05). The pooled estimate of thyroid-stimulating hormone was statistically significant after percutaneous laser ablation for 1 and 12 month ( = 0.008 and = 0.03). The pooled estimate of free triiodothyronine was no statistically significant after percutaneous laser ablation for all follow-up intervals. The pooled estimate of free tetraiodothyronin was statistically significant after percutaneous laser ablation1 month ( = 0.004). The pooled estimate of thyroglobulin was statistically significant after percutaneous laser ablation 24 month ( = 0.04). The heterogeneity was found and the source of heterogeneity was explored in nodule volume for 6 and 12 month. No publication bias was found.
This meta-analysis demonstrated that percutaneous laser ablation was safe and useful in shrinking benign thyroid nodules volume, improving thyroid function, relieving symptoms of pressure and esthetic, especial for hyper-vascular benign thyroid nodules. Larger number of high-quality prospective studies still needs to be performed.
为评估经皮激光消融术治疗良性甲状腺结节的效果，我们在总结现有研究的基础上进行了一项荟萃分析。
在PubMed、Cochrane图书馆和医学文摘数据库中进行了关于临床试验的文献检索。对纳入研究的质量进行了评估。我们计算了平均差指数。对异质性和发表偏倚进行了检验和探索。我们进一步进行了亚组分析和敏感性分析。
本荟萃分析共纳入19项研究和2137例患者。经皮激光消融术后1个月、3个月、6个月、12个月、24个月和36个月，结节体积的合并估计值具有统计学意义（<0.05）。经皮激光消融术后1个月和12个月，促甲状腺激素的合并估计值具有统计学意义（=0.008和=0.03）。在所有随访期间，经皮激光消融术后游离三碘甲状腺原氨酸的合并估计值无统计学意义。经皮激光消融术后1个月，游离甲状腺素的合并估计值具有统计学意义（=0.004）。经皮激光消融术后24个月，甲状腺球蛋白的合并估计值具有统计学意义（=0.04）。在6个月和12个月的结节体积方面发现了异质性并对异质性来源进行了探索。未发现发表偏倚。
本荟萃分析表明，经皮激光消融术在缩小良性甲状腺结节体积、改善甲状腺功能、缓解压迫症状和美观方面是安全有效的，尤其对于富血管性良性甲状腺结节。仍需要进行更多高质量的前瞻性研究。
