Yan Lin, Song Qing, Xiao Jing, Zhang Ying, Luo Yu-Kun
Department of Ultrasound,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China.
Health Management Center,The Second Hospital of Dalian Medical University,Dalian,Liaoning 116023,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Aug;43(4):584-589. doi: 10.3881/j.issn.1000-503X.13277.
Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm]treated by RFA from June 2016 to September 2018 were evaluated in this study.During the RFA procedure,enlarged ablation was performed.Patients were followed up 1,3,6,12 months after RFA and every 6 months thereafter.The volume of ablation area and the volume reduction ratio(VRR)were calculated.To evaluate the ablation performance,CNB was performed to the central zone,the peripheral zone,and surrounding thyroid parenchyma 3 or 6 months after RFA. Results The mean follow-up time was(30.04±12.41)months.The mean volume of tumor significantly decreased from(106.29±96.15)mm to(1.47±8.00)mm.Two ablated tumors were diagnosed to have residue by CNB and underwent additional RFA.No recurrence,metastatic lymph nodes,or distal metastasis were found during the follow-up.All the patients were tolerable to RFA and CNB procedure. Conclusion CNB can be used to evaluate the ablation performance after RFA for low-risk PTMC.
探讨粗针穿刺活检（CNB）对射频消融（RFA）后低危甲状腺微小乳头状癌（PTMC）的临床价值。方法：本研究纳入2016年6月至2018年9月期间接受RFA治疗的190例单灶性低危PTMC患者（包括142例女性和48例男性，年龄20 - 74岁），平均体积为（106.29±96.15）mm³。在RFA过程中进行扩大消融。患者在RFA后1、3、6、12个月进行随访，之后每6个月随访一次。计算消融区域体积和体积缩小率（VRR）。为评估消融效果，在RFA后3或6个月对中央区、外周区及周围甲状腺实质进行CNB。结果：平均随访时间为（30.04±12.41）个月。肿瘤平均体积从（106.29±96.15）mm³显著降至（1.47±8.00）mm³。2例经CNB诊断为消融后有残留的肿瘤接受了额外的RFA。随访期间未发现复发、转移性淋巴结或远处转移。所有患者对RFA和CNB操作均可耐受。结论：CNB可用于评估RFA治疗低危PTMC后的消融效果。
