超声引导下微波消融治疗甲状腺微小乳头状癌的疗效分析与评价。
Analysis and evaluation of the efficacy of ultrasound-guided microwave ablation for papillary thyroid microcarcinoma.
机构信息
Department of Abdominal Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Health Management Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
出版信息
Int J Hyperthermia. 2021;38(1):1476-1485. doi: 10.1080/02656736.2021.1988152.
OBJECTIVE
The choice of the most appropriate therapeutic approach for a diagnosed papillary thyroid microcarcinoma (PTMC) remains controversial. The present study aimed to evaluate the efficacy of microwave ablation (MWA) for unifocal PTMC with a diameter of ≤0.6 cm.
METHODS
A total of 63 consecutive patients with PTMC treated with MWA were studied retrospectively. MWA was performed using the hydrodissection technique and multidimensional fixed-needle principle. We analyzed the absorption of the MWA area and evaluated the prognosis over a follow-up period of 24 months. In addition, 83 patients with PTMC who underwent surgery were selected. The operating room characteristics and procedural complications of the two groups were compared.
RESULTS
In the MWA group, the volume of nodules ( < 0.05) decreased from 0.04 ± 0.03 cm to 0.0001 ± 0.0004 cm at the 24-month follow-up after MWA, and the volume reduction rate ( < 0.05) was 99.43 ± 1.58%. The incidence of temporary reactive hyperplastic lymphadenectasis was higher and that of other complications was lower in the MWA group than in the surgery group. One percent of the patients in the surgery group had recurrence or metastasis, but none were detected in the MWA group. The loss of thyroid tissue volume ( < 0.001), operating room time ( < 0.001), and the mean length of hospital stay ( < 0.001) were significantly lower in the MWA group than in the surgery group.
CONCLUSION
Ultrasound-guided MWA is an effective treatment strategy for unifocal PTMC with a diameter of ≤0.6 cm.
目的
对于诊断出的甲状腺微小乳头状癌（PTMC），选择最合适的治疗方法仍存在争议。本研究旨在评估微波消融（MWA）治疗最大径≤0.6cm 单发 PTMC 的疗效。
方法
回顾性分析 63 例接受 MWA 治疗的 PTMC 患者的临床资料。采用水分离技术和多维固定针原则进行 MWA。分析 MWA 区域的吸收率，并在 24 个月的随访中评估预后。此外，选择了 83 例接受手术治疗的 PTMC 患者。比较两组患者的手术室特点和手术并发症。
结果
在 MWA 组，结节体积（ < 0.05）从 MWA 后 24 个月的 0.04±0.03cm 减小到 0.0001±0.0004cm，体积减小率（ < 0.05）为 99.43±1.58%。MWA 组暂时性反应性增生性淋巴结肿大的发生率较高，其他并发症的发生率较低。手术组 1%的患者出现复发或转移，但 MWA 组未发现。MWA 组甲状腺组织体积丢失（ < 0.001）、手术时间（ < 0.001）和平均住院时间（ < 0.001）明显低于手术组。
结论
超声引导下 MWA 是治疗最大径≤0.6cm 单发 PTMC 的有效治疗策略。
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