Endocr Pract. 2018 Jun;24(6):548-555. doi: 10.4158/EP-2018-0013. Epub 2018 Apr 6.
We aimed to determine the effect of percutaneous ethanol injection (PEI) on volume of cystic and mixed thyroid nodules, thyroid function tests (TFTs), antibody titers, and cytologic changes for 1 year.
Fifty-five nodules from 53 patients with cystic and mixed properties treated with PEI were included. Nodule volumes, TFTs, and thyroid autoantibodies were analyzed at baseline, 6 months, and 12 months. Fine-needle aspiration biopsy (FNAB) was performed to PEI-treated nodules in the 12th month. Thyroid nodules were classified into three groups by structural properties (purely cystic, predominantly cystic, predominantly solid).
PEI caused a volume reduction of 80.7% at 6 months and 82.1% at 12 months, without any serious complications. PEI was repeated 1.4 ± 0.4 times with a mean total ethanol amount of 3.6 ± 3.1 mL. Volume reduction in the purely cystic nodules in the 6th and 12th months after PEI was greater than the volume reductions in predominantly cystic and predominantly solid nodules. We found that smaller nodules had greater volume reductions after PEI in the 12th month. During the study, patients remained euthyroid. Antithyroglobulin levels were decreased at 12 months. None of the FNAB results were compatible with a malignant or suspicious for malignancy cytology at the 12th month.
PEI is an effective means of treatment for benign cystic and mixed thyroid nodules, without any serious side effects. We can also assume that PEI is not a trigger for autoimmunity and malignancy development over the short term.
anti-TG = anti-thyroglobulin; anti-TPO = anti-thyroperoxidase; AUS = atypia of unknown significance; CV = coefficient of variation; FNAB = fine-needle aspiration biopsy; fT3 = free triiodothyronine; fT4 = free thyroxine; PEI = percutaneous ethanol injection; TFT = thyroid function test; TSH = thyroid-stimulating hormone; US = ultrasonography.
我们旨在确定经皮乙醇注射（PEI）对囊性和混合性甲状腺结节体积、甲状腺功能检查（TFTs）、抗体滴度和细胞学变化的影响，为期 1 年。
纳入 53 例囊性和混合性甲状腺结节患者的 55 个结节，接受 PEI 治疗。在基线、6 个月和 12 个月时分析结节体积、TFTs 和甲状腺自身抗体。在第 12 个月对接受 PEI 治疗的结节进行细针抽吸活检（FNAB）。根据结构特征（单纯囊性、主要囊性、主要实性）将甲状腺结节分为三组。
PEI 在 6 个月和 12 个月时分别导致 80.7%和 82.1%的体积减少，无任何严重并发症。PEI 重复 1.4±0.4 次，平均总乙醇量为 3.6±3.1ml。PEI 后 6 个月和 12 个月单纯囊性结节的体积减少大于主要囊性和主要实性结节的体积减少。我们发现，在第 12 个月，较小的结节经 PEI 治疗后体积减少更大。在研究期间，患者保持甲状腺功能正常。抗甲状腺球蛋白水平在 12 个月时降低。第 12 个月的所有 FNAB 结果均不符合恶性或可疑恶性细胞学。
PEI 是治疗良性囊性和混合性甲状腺结节的有效方法，无任何严重副作用。我们还可以假设，在短期内，PEI 不是自身免疫和恶性肿瘤发展的触发因素。
抗 TG = 抗甲状腺球蛋白；抗 TPO = 抗甲状腺过氧化物酶；AUS = 意义不明的不典型；变异系数 = CV；FNAB = 细针抽吸活检；游离三碘甲状腺原氨酸 = fT3；游离甲状腺素 = fT4；经皮乙醇注射 = PEI；甲状腺功能检查 = TFT；促甲状腺激素 = TSH；超声 = US。
