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良性、无功能性甲状腺结节射频消融术后甲状腺功能变化趋势:单中心回顾性研究。

Trends in thyroid function following radiofrequency ablation of benign, nonfunctioning thyroid nodules: A single institution review.

机构信息

Division of GI/Endocrine Surgery, Columbia University, New York, NY, USA.

Division of GI/Endocrine Surgery, Columbia University, New York, NY, USA.

出版信息

Am J Surg. 2024 Nov;237:115793. doi: 10.1016/j.amjsurg.2024.115793. Epub 2024 Jun 5.

DOI:10.1016/j.amjsurg.2024.115793
PMID:38879355
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11438571/
Abstract

BACKGROUND

Radiofrequency ablation (RFA) effectively reduces volume and improves symptoms of benign, non-functioning thyroid nodules (NFTNs). Given RFA's unclear impact on thyroid function, we examined post-RFA trends in thyroid hormones and antibodies.

METHODS

A retrospective cross-sectional analysis was conducted of patients treated at Columbia University with RFA for benign NFTNs between August 2019 and July 2023. Thyroid function tests were recorded pre-RFA and repeated 3, 6, and 12 months post-RFA.

RESULTS

We analyzed 185 patients with 243 benign NFTNs who underwent RFA. Volume reduction ratio increased post-RFA. Mean TSH increased to 2.4 mlU/L (p ​= ​0.005) at 3 months post-RFA and decreased to 1.8 mlU/L (p ​= ​0.551) by 12 months post-RFA. Tg and TPO antibody levels peaked at 6 months post-RFA (103.1 IU/mL, p ​= ​0.868 and 66.6 IU/mL, p ​= ​0.523, respectively).

CONCLUSIONS

With expected volume reduction post-RFA, we observed transient relative hypothyroidism as well as transient increases in thyroid antibodies, with normalization of these changes within 12 months.

摘要

背景

射频消融术(RFA)可有效缩小良性、非功能性甲状腺结节(NFTN)的体积并改善其症状。鉴于 RFA 对甲状腺功能的影响尚不明确,我们检测了 RFA 后甲状腺激素和抗体的变化趋势。

方法

本研究采用回顾性队列研究方法,选取 2019 年 8 月至 2023 年 7 月期间在哥伦比亚大学接受 RFA 治疗的良性 NFTN 患者进行分析。在 RFA 治疗前和治疗后 3、6 和 12 个月记录甲状腺功能检查结果。

结果

共纳入 185 例 243 个良性 NFTN 患者,所有患者均接受 RFA 治疗。RFA 治疗后,甲状腺结节体积缩小,平均 TSH 水平在 3 个月时升高至 2.4 mIU/L(p = 0.005),12 个月时下降至 1.8 mIU/L(p = 0.551)。Tg 和 TPO 抗体水平在 6 个月时达到峰值(分别为 103.1 IU/mL 和 66.6 IU/mL,p = 0.868 和 p = 0.523)。

结论

RFA 治疗后甲状腺结节体积缩小,观察到短暂的相对甲状腺功能减退症和甲状腺抗体一过性升高,这些变化在 12 个月内恢复正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/024ec0f96b60/nihms-2003512-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/073f5413d8f9/nihms-2003512-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/399fabe9ea59/nihms-2003512-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/024ec0f96b60/nihms-2003512-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/073f5413d8f9/nihms-2003512-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/399fabe9ea59/nihms-2003512-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d34/11438571/024ec0f96b60/nihms-2003512-f0003.jpg

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Front Endocrinol (Lausanne). 2022 Oct 17;13:902484. doi: 10.3389/fendo.2022.902484. eCollection 2022.
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Thyroid Nodule Radiofrequency Ablation: Complications and Clinical Follow Up.甲状腺结节射频消融:并发症与临床随访
Tech Vasc Interv Radiol. 2022 Jun;25(2):100824. doi: 10.1016/j.tvir.2022.100824. Epub 2022 Mar 10.
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Efficacy in size and symptom reduction of radiofrequency ablation of benign non-functioning thyroid nodules.射频消融治疗良性非功能性甲状腺结节的大小和症状缓解效果。
Endocrinol Diabetes Nutr (Engl Ed). 2022 Mar;69(3):194-200. doi: 10.1016/j.endien.2022.02.018.
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Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association.射频消融及相关超声引导消融技术治疗甲状腺良恶性疾病:美国头颈学会内分泌外科分会与亚太甲状腺外科学会、意大利内分泌外科学会、英国内分泌和甲状腺外科学会、欧洲甲状腺协会、意大利内分泌外科单位协会、韩国甲状腺放射学会、拉丁美洲甲状腺学会以及甲状腺结节治疗协会联合发布的国际多学科共识声明。
Head Neck. 2022 Mar;44(3):633-660. doi: 10.1002/hed.26960. Epub 2021 Dec 23.
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