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.
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.
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。
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