Sun Wei, Zhang Hao, He Liang, Zhang Ting, Wang Zhihong, Dong Wenwu, Jiang Yingling
Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).
Department of Thyroid Surgeryy, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).
Med Sci Monit. 2020 Nov 22;26:e928391. doi: 10.12659/MSM.928391.
BACKGROUND Radiofrequency ablation (RFA) is used to treat various cancers, but its use in thyroid cancer remains controversial. The aim of this study was to investigate surgical findings after RFA for papillary thyroid cancer (PTC). MATERIAL AND METHODS The study included 21 patients (average age 44.9±13.3 years) who had biopsy-confirmed thyroid cancer treated with RFA in multiple hospitals. Surgery was done in the First Hospital of China Medical University. RESULTS The 21 patients had a total of 32 thyroid nodules that were treated with RFA. Twenty-eight nodules were malignant, and 4 nodules were benign. Before RFA, 17 of the malignant nodules were >1 cm and 11 were ≤1 cm. Among the 28 malignant nodules, post-ablation lesions adhered to or invaded the structures surrounding the thyroid in 17 (60.7%), 19 (67.9%), and 22 (78.6%) nodules evaluated with ultrasound, contrast-enhanced computed tomography, and intraoperatively, respectively. Based on pathology results, 7 (33.3%) of the 21 patients had bilateral cancer. Ten (47.6%) of the 21 patients had central lymph node metastasis and 2 (9.5%) had lateral lymph node metastasis. For 5 (15.6%) of the 32 nodules, the fine-needle aspiration results were not consistent with the postoperative pathological results. Five (23.8%) of the 21 patients with lymph node metastasis had clinically negative (CN0) lesions. CONCLUSIONS RFA for PTC primary lesions may be incomplete and leave residual lymph node metastasis, even in lesions ≤1 cm. RFA should be recommended with caution in the treatment of operable patients with primary PTC.
背景 射频消融（RFA）用于治疗多种癌症，但其在甲状腺癌中的应用仍存在争议。本研究旨在调查甲状腺乳头状癌（PTC）射频消融术后的手术发现。材料与方法 本研究纳入了21例患者（平均年龄44.9±13.3岁），这些患者经活检确诊为甲状腺癌，在多家医院接受了射频消融治疗。手术在中国医科大学附属第一医院进行。结果 21例患者共有32个甲状腺结节接受了射频消融治疗。28个结节为恶性，4个结节为良性。射频消融前，17个恶性结节直径>1 cm，11个≤1 cm。在28个恶性结节中，分别通过超声、增强计算机断层扫描和术中评估发现，消融后病变分别有17个（60.7%）、19个（67.9%）和22个（78.6%）与甲状腺周围结构粘连或侵犯。根据病理结果，21例患者中有7例（33.3%）为双侧癌。21例患者中有10例（47.6%）发生中央淋巴结转移，2例（9.5%）发生侧方淋巴结转移。32个结节中有5个（15.6%）细针穿刺结果与术后病理结果不一致。21例发生淋巴结转移的患者中有5例（23.8%）临床检查为阴性（CN0）病变。结论 即使对于直径≤1 cm的病变，PTC原发灶的射频消融可能也不彻底，并可能残留淋巴结转移。对于可手术的原发性PTC患者，应谨慎推荐射频消融治疗。
