Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China 410013.
Biomed Res Int. 2021 Jul 23;2021:6616826. doi: 10.1155/2021/6616826. eCollection 2021.
To evaluate the long-term efficacy and safety of ultrasound-guided percutaneous laser ablation (PLA) for the treatment of low-risk papillary thyroid microcarcinoma (PTMC).
From June 2012 to May 2015, 105 patients with solitary, pathologically confirmed PTMC lesions were treated with ultrasound-guided PLA. Nodule location, nodule volume, thyroid function, and clinical symptoms were evaluated before ablation. Contrast-enhanced ultrasound (CEUS) was performed 1 h after treatment to evaluate whether the ablation was complete. Ultrasound examination was performed at 1, 3, 6, and 12 months after ablation and every 6 months thereafter to determine the size of the ablation area and search for recurrence in the thyroid parenchyma and lymph node metastasis. Thyroid function was examined before and 1 month after ablation. Fine needle aspiration biopsy was performed for any suspicious metastatic lymph nodes and recurrent lesions in the thyroid.
All 105 lesions were completely inactivated after one ablation, making the success rate for single ablation 100%. The average ablation time was 2.78 ± 1.05 min, and the average ablation energy was 505 ± 185 J. All patients could tolerate and complete the ablation. No serious complications occurred during the treatment; only minor side effects such as pain and local discomfort were reported. The volume reduction rates were -781.14 ± 653.29% at 1 h posttreatment and -268.65 ± 179.57%, -98.39 ± 76.58%, 36.78 ± 30.32%, 75.55 ± 21.81%, 96.79 ± 10.57%, and 100% at 1, 3, 6, 12, 18, and 24 months after ablation, respectively. This rate remained 100% at the later follow-up times. Overall, 28 (26.67%), 74 (70.48%), 96 (91.43%), and 103 (100%) were completely absorbed by 6, 12, 18, and 24 months after PLA. One patient developed another lesion 12 months after ablation, and two patients had central cervical lymph node metastasis 24 months after ablation.
PLA is a safe and effective alternative clinical treatment for low-risk PTMC.
评估超声引导经皮激光消融（PLA）治疗低危甲状腺微小乳头状癌（PTMC）的长期疗效和安全性。
2012 年 6 月至 2015 年 5 月，对 105 例经病理证实的单发低危 PTMC 患者进行了超声引导下 PLA 治疗。消融前评估结节位置、结节体积、甲状腺功能和临床症状。治疗后 1 小时行超声造影（CEUS）检查以评估消融是否完全。消融后 1、3、6、12 个月及以后每 6 个月进行超声检查，以确定消融区域的大小，并在甲状腺实质和颈部淋巴结转移中寻找复发情况。消融前和消融后 1 个月检查甲状腺功能。对任何可疑转移淋巴结和甲状腺复发病灶进行细针抽吸活检。
105 个病灶均经单次消融完全灭活，单次消融成功率为 100%。平均消融时间为 2.78±1.05 分钟，平均消融能量为 505±185J。所有患者均能耐受并完成消融。治疗过程中未发生严重并发症，仅报告有轻微的疼痛和局部不适等不良反应。治疗后 1 小时的体积缩小率为-781.14±653.29%，1、3、6、12、18 和 24 个月时分别为-268.65±179.57%、-98.39±76.58%、36.78±30.32%、75.55±21.81%、96.79±10.57%和 100%。在以后的随访中，该比例一直保持在 100%。总体而言，28（26.67%）、74（70.48%）、96（91.43%）和 103（100%）例患者分别在 PLA 后 6、12、18 和 24 个月完全吸收。1 例患者在消融后 12 个月出现另一病灶，2 例患者在消融后 24 个月出现中央颈部淋巴结转移。
PLA 是治疗低危 PTMC 的一种安全有效的替代临床治疗方法。
