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双极射频消融诱导甲状腺结节的形态学变化——一项临床前研究

Morphological Changes Induced by Bipolar Radiofrequency Ablation in Thyroid Nodules - a Preclinical Investigation.

作者信息

Branovan Daniel Igor, Fridman Mikhail, Lushchyk Maxim, Drozd Valentina, Krasko Olga, Nedzvedz Olga, Shiglik Nikolay, Danilova Larisa

机构信息

Project Chernobyl, New York, United States.

Minsk City Clinical Oncologic Dispensary, Minsk, Belarus.

出版信息

Eur Endocrinol. 2016 Aug;12(2):85-88. doi: 10.17925/EE.2016.12.02.85. Epub 2016 Aug 28.

DOI:10.17925/EE.2016.12.02.85
PMID:29632593
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5813447/
Abstract

Recently, radiofrequency ablation (RFA) has been increasingly used for the treatment of thyroid nodules. However, immediate morphological changes associated with bipolar devices are poorly shown. To present the results of analysis of gross and microscopic alterations in human thyroid tissue induced by RFA delivered through the application of the original patented device. In total, there were 37 surgically removed thyroid glands in females aged 32-67 at presentation: 16 nodules were follicular adenoma (labelled as 'parenchymal' solid benign nodules) and adenomatous colloid goitre was represented by 21 cases. The thyroid gland was routinely processed and the nodules were sliced into two parts - one was a subject for histological routine processing according to the principles that universally apply in surgical pathology, the other one was used for the RFA procedure. No significant difference in size reduction between parenchymal and colloid nodules was revealed (p>0.1, t-test) straight after the treatment. In addition, RFA equally effectively induced necrosis in follicular adenoma and adenomatous colloid goitre (p>0.1, analysis of variance test). As expected, tumour size correlated with size reduction (the smaller the size of the nodule, the greater percentage of the nodule volume that was ablated): r=-0.48 (p<0.0001). The results make it possible to move from experiments to clinical practice.

摘要

近年来,射频消融(RFA)已越来越多地用于治疗甲状腺结节。然而,与双极设备相关的即时形态学变化鲜有展示。本研究旨在呈现通过应用原始专利设备进行RFA后,人体甲状腺组织大体和微观改变的分析结果。本研究共纳入37例手术切除的甲状腺,患者为32至67岁的女性:16个结节为滤泡性腺瘤(标记为“实质性”实性良性结节),21例为腺瘤性胶样甲状腺肿。甲状腺按常规方法处理,结节切成两部分——一部分按照手术病理学普遍适用的原则进行组织学常规处理,另一部分用于RFA操作。治疗后即刻,实质性结节和胶样结节在大小缩小方面未显示出显著差异(p>0.1,t检验)。此外,RFA在滤泡性腺瘤和腺瘤性胶样甲状腺肿中同样有效地诱导了坏死(p>0.1,方差分析检验)。正如预期的那样,肿瘤大小与缩小程度相关(结节越小,被消融的结节体积百分比越大):r=-0.48(p<0.0001)。这些结果使得从实验转向临床实践成为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/50c2c56095c0/euendo-12-85-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/dd7d88d66ff1/euendo-12-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/b257a2be0921/euendo-12-85-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/81a3e6f9a974/euendo-12-85-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/26ec0d1b2882/euendo-12-85-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/07ca77f6c415/euendo-12-85-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/50c2c56095c0/euendo-12-85-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/dd7d88d66ff1/euendo-12-85-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/b257a2be0921/euendo-12-85-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/81a3e6f9a974/euendo-12-85-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/26ec0d1b2882/euendo-12-85-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/07ca77f6c415/euendo-12-85-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c9c/5813447/50c2c56095c0/euendo-12-85-g006.jpg

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本文引用的文献

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Increasing Incidence of Thyroid Nodules and Thyroid Cancer: Does Increased Detection of a Subclinical Reservoir Justify the Associated Anxiety and Treatment?甲状腺结节和甲状腺癌发病率上升:亚临床病灶检出率的增加是否足以解释相关的焦虑情绪和治疗行为?
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Thyroid malignancy markers on sonography are common in patients with benign thyroid disease and previous iodine deficiency.
超声检查发现的甲状腺恶性肿瘤标志物在患有良性甲状腺疾病和既往碘缺乏的患者中很常见。
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