Song Qing, Gao Hanjing, Tian Xiaoqi, Ren Ling, Lan Yu, Yan Lin, Luo Yukun
Department of Ultrasound, First Medical Center of General Hospital of Chinese PLA, Beijing, China.
Department of Ultrasound, Seventh Medical Center, General Hospital of Chinese PLA, Beijing, China.
Front Endocrinol (Lausanne). 2021 Feb 9;11:599471. doi: 10.3389/fendo.2020.599471. eCollection 2020.
About 3-9.2% of papillary thyroid carcinomas (PTC) are found in the isthmus, which has unique anatomic properties, making treatment more challenging. The aim of this study was to evaluate the treatment and undesirable effects of ultrasound-guided radiofrequency ablation (RFA) for PTC in the isthmus.
This retrospective case series study assessed 112 patients with single papillary thyroid microcarcinoma in the isthmus, pathologically diagnosed before RFA at the General Hospital of Chinese PLA in 2014-2018. Follow-up was performed by contrast-enhanced ultrasound (CEUS) and ultrasound examinations at 1, 3, and 6 months and every 6 months thereafter. The complete ablation (CAR), disappearance (DR), and volume reduction (VRR) rates of nodules, the incidence of complications, and the rate of lymph-node metastasis were recorded.
The CAR of the tumors was 100%. During follow-up, the volume of coagulation necrosis gradually decreased. DRs at 1, 3, 6, 12, and 18 months after RFA were 0.8% (1/112), 10.7% (12/112), 51.7% (58/112), 91.0% (102/112), and 100% (112/112), respectively. The VRR evaluated by ultrasound and CEUS gradually increased. One recurrent case (0.8%) was found at 7 months after RFA. No complications, lymph node metastasis confirmed by ultrasound, and abnormal thyroid function were observed.
This retrospective study shows that RFA is beneficial for the treatment of PTMC in the isthmus.
约3%-9.2%的甲状腺乳头状癌（PTC）发生于峡部，峡部具有独特的解剖学特性，使得治疗更具挑战性。本研究旨在评估超声引导下射频消融（RFA）治疗峡部PTC的疗效及不良反应。
本回顾性病例系列研究评估了112例峡部单发甲状腺微小乳头状癌患者，这些患者于2014年至2018年在中国人民解放军总医院接受RFA治疗前经病理确诊。在术后1、3、6个月及之后每6个月通过超声造影（CEUS）和超声检查进行随访。记录结节的完全消融率（CAR）、消失率（DR）和体积缩小率（VRR）、并发症发生率及淋巴结转移率。
肿瘤的CAR为100%。随访期间，凝固性坏死体积逐渐减小。RFA术后1、3、6、12和18个月的DR分别为0.8%（1/112）、10.7%（12/112）、51.7%（58/112）、91.0%（102/112）和100%（112/112）。通过超声和CEUS评估的VRR逐渐增加。RFA术后7个月发现1例复发病例（0.8%）。未观察到并发症、超声证实的淋巴结转移及甲状腺功能异常。
这项回顾性研究表明，RFA对峡部甲状腺微小乳头状癌的治疗有益。
