Department of Ultrasound, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Pathology, Chinese People's Liberation Army General Hospital, Beijing, China.
Cancer Med. 2019 Sep;8(12):5450-5458. doi: 10.1002/cam4.2406. Epub 2019 Jul 30.
Chronic lymphocytic thyroiditis (CLT) is an autoimmune disease commonly associated with papillary thyroid carcinoma characterized by a smaller primary tumor size at presentation. The efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) coexisting with CLT is still unknown.
Sixty patients with unifocal PTMC were enrolled and classified into PTMC and PTMC+CLT groups (n = 30/group). CLT was diagnosed histopathologically. The ablation area exceeded the tumor margins, and was evaluated by US and contrast-enhanced US (CEUS) for residual tumor to prevent recurrence. Three months after ablation, US-guided core-needle biopsy was performed to assess the presence of residual and recurrent cancer. Preoperative and postoperative data on patients and tumors were recorded and analyzed.
There were no differences between groups in age, sex, preoperative tumor volume, ablation time, or ablation power (P > 0.05). There was also no significant difference in postoperative ablation zone volume between the groups at the 1-, 3-, 6-, 12-, and 18-month follow-ups (P > 0.05). The volume reduction rate significantly differed between the two groups at month 3 (P = 0.03). The ablation area could not be identified on US and CEUS at 9.8 ± 5.0 and 10.0 ± 4.8 months in the PTMC and PTMC + CLT groups, respectively (P = 0.197). No serious complications occurred during and after ablation. No residual cancer cells were found on biopsy after ablation.
RFA was effective in patients with PTMC+CLT, and its therapeutic efficacy and safety were similar to those in patients with PTMC without CLT.
慢性淋巴细胞性甲状腺炎（CLT）是一种自身免疫性疾病，常与甲状腺乳头状癌相关，其特征是在发病时原发性肿瘤较小。超声引导下射频消融（RFA）治疗合并 CLT 的甲状腺微小乳头状癌（PTMC）的疗效和安全性尚不清楚。
共纳入 60 例单灶性 PTMC 患者，分为 PTMC 组和 PTMC+CLT 组（每组 30 例）。CLT 经组织病理学诊断。消融区域超过肿瘤边缘，通过超声和超声造影（CEUS）评估残余肿瘤以预防复发。消融后 3 个月，行超声引导下核心针活检以评估有无残余和复发癌。记录和分析患者和肿瘤的术前及术后数据。
两组患者年龄、性别、术前肿瘤体积、消融时间、消融功率比较，差异均无统计学意义（P>0.05）。两组术后 1、3、6、12、18 个月的消融区体积比较，差异均无统计学意义（P>0.05）。术后 3 个月两组的体积减少率比较，差异有统计学意义（P=0.03）。PTMC 组和 PTMC+CLT 组分别在 9.8±5.0 个月和 10.0±4.8 个月时在 US 和 CEUS 上无法识别消融区（P=0.197）。消融过程中和消融后均无严重并发症发生。消融后活检未发现残留癌细胞。
RFA 治疗合并 CLT 的 PTMC 患者有效，其疗效和安全性与不合并 CLT 的 PTMC 患者相似。
