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微波消融治疗甲状腺微小乳头状癌的五年随访报告。

Effects of Microwave Ablation on Papillary Thyroid Microcarcinoma: A Five-Year Follow-Up Report.

机构信息

Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China.

Department of Ultrasound, The First Hospital of Jilin University, Changchun, China.

出版信息

Thyroid. 2020 Dec;30(12):1752-1758. doi: 10.1089/thy.2020.0049. Epub 2020 Jun 30.

Abstract

Some researchers have achieved favorable efficacy in the treatment of primary papillary thyroid microcarcinoma (PTMC) using microwave ablation (MWA). However, as PTMC is a slowly progressing disease, a long follow-up period is required to confirm treatment efficacy. Our study aim was to investigate the long-term efficacy and safety of ultrasound (US)-guided MWA in PTMC. In this study, 41 patients with thyroid masses (41 nodules) were diagnosed with PTMC by fine-needle aspiration or core needle biopsy. They underwent US-guided MWA. Preablation ultrasonic images of the thyroid nodules were collected, and the volumes were measured. The patients had follow-up at 1, 3, 6, and 12 months in the first year and every 6 months from the second year on, after MWA. The volume reduction rates (VRRs) of the thyroid nodules were analyzed. In total, 40 of 41 nodules were completely ablated by MWA. After 60 months of follow-up, the volume significantly decreased from a median of 55.78 mm (quartile: 21.50, 112.20 mm) to 0 mm (0, 0 mm) ( < 0.001), with a VRR of 99.37% ± 4.02%. Two patients developed hoarseness after ablation; one recovered within 10 minutes, and the hoarseness in the other patient resolved 2 months after the ablation. No recurrence, metastatic cervical lymph nodes, or distal metastasis was found during the follow-up period. In this five-year follow-up, MWA presented favorable efficacy with satisfactory safety for the treatment of PTMC. It should be considered an alternative therapy to surgery and active surveillance for solitary PTMC.

摘要

一些研究人员在使用微波消融(MWA)治疗原发性甲状腺微小乳头状癌(PTMC)方面取得了良好的疗效。然而,由于 PTMC 是一种进展缓慢的疾病,需要进行长期随访以确认治疗效果。本研究旨在探讨超声引导下 MWA 治疗 PTMC 的长期疗效和安全性。

在这项研究中,41 例甲状腺肿块(41 个结节)患者经细针抽吸或核心针活检诊断为 PTMC,行超声引导下 MWA。在 MWA 前采集甲状腺结节的超声图像,并测量其体积。患者在 MWA 后第 1 年的 1、3、6 和 12 个月进行随访,从第 2 年起每 6 个月进行一次随访。分析甲状腺结节的体积缩小率(VRR)。

MWA 完全消融了 41 个结节中的 40 个。随访 60 个月后,结节体积从中位数 55.78mm(四分位间距:21.50,112.20mm)显著减少至 0mm(0,0mm)( < 0.001),VRR 为 99.37% ± 4.02%。2 例患者消融后出现声音嘶哑,1 例患者 10 分钟内恢复,另 1 例患者在消融后 2 个月声音嘶哑缓解。随访期间未发现复发、转移性颈淋巴结或远处转移。

在这项 5 年随访中,MWA 治疗 PTMC 的疗效良好,安全性满意,可作为手术和主动监测治疗单发 PTMC 的替代疗法。

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