Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Endocrinol (Lausanne). 2022 Aug 2;13:929651. doi: 10.3389/fendo.2022.929651. eCollection 2022.
The incidence of papillary thyroid carcinoma (PTC) has rapidly increased in recent years. Microwave ablation (MWA) was proposed as an alternative treatment for PTC. This study aimed to investigate the efficacy and safety of MWA by exploring the postoperative pathology results of post-ablation lesions in patients with PTC.
This study retrospectively analyzed data from 12 patients who underwent thyroid surgery after MWA treatment for primary PTC between January 2015 and November 2021 in six hospitals.
The average age of the 12 patients (8 female) was 45.3 ± 9.7 years. There was one patient with PTC (size > 1 cm) and 11 patients with micro-PTC (size ≤ 1 cm), of which eight patients had unifocal micro-PTC and three patients had multifocal micro-PTC. A total of 17 tumor foci with mean size of 6.2 ± 2.6 mm were treated by MWA. The median interval time between MWA and surgery was 6.6 months (range: 0.4-21.9 months). Intraoperatively, adherence to the anterior cervical muscle group was observed in three cases (3/12). Upon postoperative pathologic examination, all the post-ablation lesions of the eight unifocal micro-PTC and two multifocal micro-PTC showed no residual carcinomas. Outside the ablation zone, PTCs were detected in three cases, including two of the eight patients with unifocal micro-PTC and one of the three patients with multifocal micro-PTC. Cervical lymph node metastases were detected in seven patients (7/12).
MWA was feasible for the treatment of primary unifocal low-risk micro-PTC (T1aN0M0) with good efficacy and safety. However, the use of MWA for treating PTC (size > 1 cm) and multifocal micro-PTC remains controversial.
近年来，甲状腺乳头状癌（PTC）的发病率迅速上升。微波消融（MWA）被提出作为 PTC 的一种替代治疗方法。本研究旨在通过探索 PTC 患者消融后病变的术后病理学结果来研究 MWA 的疗效和安全性。
本研究回顾性分析了 2015 年 1 月至 2021 年 11 月期间，六家医院的 12 例接受 MWA 治疗后行甲状腺手术的初发 PTC 患者的数据。
12 例患者（8 例女性）的平均年龄为 45.3 ± 9.7 岁。其中 1 例为 PTC（大小> 1cm），11 例为微 PTC（大小≤1cm），其中 8 例为单灶微 PTC，3 例为多灶微 PTC。共对 17 个大小平均为 6.2 ± 2.6mm 的肿瘤病灶进行了 MWA 治疗。MWA 与手术之间的中位间隔时间为 6.6 个月（范围：0.4-21.9 个月）。术中观察到 3 例（3/12）与前颈肌组粘连。术后病理检查发现，8 例单灶微 PTC 和 2 例多灶微 PTC 的所有消融后病变均无残留癌。在消融区外，3 例发现 PTC，其中 2 例为 8 例单灶微 PTC 患者之一，1 例为 3 例多灶微 PTC 患者之一。7 例患者（7/12）发现颈部淋巴结转移。
MWA 治疗初发单发低危微 PTC（T1aN0M0）是可行的，具有良好的疗效和安全性。然而，MWA 治疗 PTC（大小> 1cm）和多灶微 PTC 的应用仍存在争议。
