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超声引导激光消融与微波消融治疗单发甲状腺微小乳头状癌的回顾性研究。

Ultrasound-Guided Laser Ablation Versus Microwave Ablation for Patients With Unifocal Papillary Thyroid Microcarcinoma: A Retrospective Study.

机构信息

Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, 197 Ruijin 2 Rd, Shanghai, 200025, China.

出版信息

Lasers Surg Med. 2020 Nov;52(9):855-862. doi: 10.1002/lsm.23238. Epub 2020 Mar 26.

Abstract

BACKGROUND AND OBJECTIVES

The objective of this study is to compare the efficacy and the safety of ultrasound-guided microwave ablation (MWA) and laser ablation (LA) for the treatment of papillary thyroid microcarcinoma (PTMC).

STUDY DESIGN/MATERIALS AND METHODS: A total of 67 patients with unifocal PTMC were studied retrospectively, including 33 cases who underwent MWA (MWA group) and 34 cases who received LA (LA group). The follow-up consisted of thyroid function tests, ultrasonography, contrast-enhanced ultrasonography (CEUS), and chest X-ray or computed tomography scan. The treatment response and complications were compared between the two groups.

RESULTS

The follow-up time for the MWA and LA group was 23.3 ± 4.4 and 22.8 ± 4.1 months, respectively. All the ablations were successfully performed as planned without complementary ablations, and it was confirmed by CEUS after treatment in both groups. It was observed that, at the last follow-up, the mean largest diameter decreased from 5.0 ± 1.4 mm to 0.1 ± 0.4 mm (MWA group) and from 4.5 ± 1.6 mm to 0.6 ± 1.2 mm(LA group) (P < 0.05 for both). The average volume reduced from 51.9 ± 40.8 to 0.2 ± 1.0 mm (MWA group) and from 38.5 ± 43.0 to 1.3 ± 3.8 mm (LA group) (P < 0.05 for both). The complication rates did not differ between the MWA group (9.1%) and the LA group (2.9%) (P > 0.05). No local recurrence or distant metastasis occurred in either group.

CONCLUSIONS

During the short-term follow-up period, ultrasound-guided MWA and LA were both safe and effective methods in treating patients with unifocal PTMC. Lasers Surg. Med. © 2020 Wiley Periodicals, Inc.

摘要

背景与目的

本研究旨在比较超声引导下微波消融(MWA)和激光消融(LA)治疗甲状腺微小乳头状癌(PTMC)的疗效和安全性。

研究设计/材料和方法:回顾性分析了 67 例单灶性 PTMC 患者的临床资料,其中 33 例行 MWA(MWA 组),34 例行 LA(LA 组)。随访包括甲状腺功能检查、超声、超声造影(CEUS)、胸部 X 线或 CT 扫描。比较两组患者的治疗反应和并发症。

结果

MWA 组和 LA 组的随访时间分别为 23.3±4.4 个月和 22.8±4.1 个月。两组均成功按计划完成消融治疗,且治疗后均经 CEUS 证实。末次随访时,MWA 组最大直径由治疗前的 5.0±1.4mm 缩小至 0.1±0.4mm(P<0.05),体积由 51.9±40.8mm 缩小至 0.2±1.0mm(P<0.05);LA 组最大直径由治疗前的 4.5±1.6mm 缩小至 0.6±1.2mm(P<0.05),体积由 38.5±43.0mm 缩小至 1.3±3.8mm(P<0.05)。MWA 组并发症发生率为 9.1%(3/33),LA 组为 2.9%(1/34),两组差异无统计学意义(P>0.05)。两组均无局部复发或远处转移。

结论

在短期随访中,超声引导下 MWA 和 LA 治疗单灶性 PTMC 均安全有效。

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