Department of Ultrasound, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.
Int J Hyperthermia. 2022;39(1):490-496. doi: 10.1080/02656736.2022.2047231.
To investigate the efficacy of radiofrequency ablation (RFA) as a treatment option for primary hyperparathyroidism (pHPT) and risk factors for postablative eucalcemic parathyroid hormone elevation (ePTH).
This retrospective study included 51 patients with pHPT who underwent RFA. The patients were divided into the ePTH and normal PTH groups, based on the serum intact parathyroid hormone (iPTH) level one month after ablation. Serum iPTH, calcium, and phosphorus levels, and the volume reduction rates (VRR) of the parathyroid glands were compared between the groups at each follow-up point. Risk factors for ePTH at one month after ablation were examined.
After RFA, one (2%) patient had persistent pHPT, and 50 (98%) patients were cured. The incidence rates of ePTH at 1, 3, 6, and 12 months were 48%, 30%, 20%, and 16%, respectively. Serum iPTH levels in the ePTH group were higher than those in the normal PTH group at each follow-up point (all < 0.05), except 1 day after ablation ( > 0.05). Serum calcium and phosphorus levels, and the VRR of the glands were comparable in both groups at each follow-up point (all > 0.05), except for calcium levels 3 days after RFA ( < 0.05). Baseline iPTH (odds ratio, 1.067; = 0.045) and calcium (odds ratio, 3.923; = 0.038) levels were independent risk factors for ePTH 1 month after RFA.
RFA is safe and effective for the treatment of pHPT. Moreover, ePTH occurrence after RFA was associated with baseline iPTH and calcium levels and did not increase the risk of recurrent pHPT.
探讨射频消融术（RFA）治疗原发性甲状旁腺功能亢进症（pHPT）的疗效及消融后血钙正常甲状旁腺激素升高（ePTH）的危险因素。
本回顾性研究纳入了 51 例 pHPT 患者，均行 RFA 治疗。根据消融后 1 个月血清全段甲状旁腺激素（iPTH）水平将患者分为 ePTH 组和正常 PTH 组。比较两组患者在每个随访时间点的血清 iPTH、钙、磷水平及甲状旁腺体积缩小率（VRR）。分析消融后 1 个月发生 ePTH 的危险因素。
RFA 后 1 例（2%）患者 pHPT 持续存在，50 例（98%）患者治愈。消融后 1、3、6 和 12 个月时 ePTH 的发生率分别为 48%、30%、20%和 16%。ePTH 组患者在每个随访时间点的血清 iPTH 水平均高于正常 PTH 组（均 < 0.05），但在消融后 1 天除外（ > 0.05）。两组患者在每个随访时间点的血清钙、磷水平及腺体 VRR 比较，差异均无统计学意义（均 > 0.05），但在 RFA 后 3 天除外钙水平（ < 0.05）。基线 iPTH（比值比，1.067； = 0.045）和钙（比值比，3.923； = 0.038）水平是 RFA 后 1 个月发生 ePTH 的独立危险因素。
RFA 治疗 pHPT 安全有效，且 ePTH 的发生并不增加 pHPT 复发的风险，与基线 iPTH 和钙水平有关。
