Guang Yang, Luo Yu-Kun, Zhang Yan, Zhang Ming-Bo, Li Nan, Zhang Ying, Tang Jie
Department of Ultrasound,Chinese PLA General Hospital,Beijing 100853,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Feb 28;40(1):67-71. doi: 10.3881/j.issn.1000-503X.2018.01.010.
Objective To assess the effectiveness and safety of ultrasound-guided percutaneous radiofrequency ablation (RFA) for nonsurgical treatment of metastatic lymph nodes (LNs) in the neck from papillary thyroid carcinoma (PTC). Methods Totally 45 PTC patients who had been treated with total thyroidectomy and radioiodine therapy were enrolled in this retrospective study. A total of 71 metastatic LNs in the neck from PTC were confirmed by percutaneous biopsy. Follow-up consisted of conventional ultrasound,contrast-enhanced ultrasound,and thyroglobulin (Tg) measurement 1,3 and 6 months after RFA and then every 6 months. Results All 45 patients were successfully treated,without immediate or later major complications occurred. During the follow-up [(23±5) months;range:12-30 months)],there was no evidence of recurrence at ablated sites. The mean volume reduction ratio (VRR) was significantly reduced during the follow-up. Significant differences in the VRR were found between every two follow-up visits (P<0.001). Furthermore,46 metastatic LNs (64.8%) completely disappeared and 25 metastatic lymph nodes (35.2%) remained as small scar-like lesions at the last follow-up visit. After RFA,mean serum Tg level decreased from (11.3±6.3)ng/ml (range:0.8-19.4 ng/ml) to (1.3±0.9)ng/ml (range:0.2-3.9 ng/ml) at the last follow-up visit (P<0.001). Conclusion Ultrasound-guided percutaneous RFA is a safe and effective therapy for patients with cervical LNs metastasis from PTC.
目的 评估超声引导下经皮射频消融（RFA）治疗甲状腺乳头状癌（PTC）颈部转移性淋巴结（LNs）的有效性和安全性。方法 本回顾性研究纳入45例接受甲状腺全切除术和放射性碘治疗的PTC患者。经皮活检证实共有71个PTC颈部转移性淋巴结。随访包括在RFA后1、3和6个月以及之后每6个月进行的常规超声、超声造影和甲状腺球蛋白（Tg）测量。结果 45例患者均成功治疗，未发生即刻或后期严重并发症。在随访期间[（23±5）个月；范围：12 - 30个月]，消融部位无复发迹象。随访期间平均体积缩小率（VRR）显著降低。每次随访之间VRR存在显著差异（P<0.001）。此外，在最后一次随访时，46个转移性淋巴结（64.8%）完全消失，25个转移性淋巴结（35.2%）仍为小瘢痕样病变。RFA后，最后一次随访时血清Tg平均水平从（11.3±6.3）ng/ml（范围：0.8 - 19.4 ng/ml）降至（1.3±0.9）ng/ml（范围：0.2 - 3.9 ng/ml）（P<0.001）。结论 超声引导下经皮RFA是治疗PTC颈部LN转移患者的一种安全有效的疗法。
