Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
Front Endocrinol (Lausanne). 2024 Aug 6;15:1430693. doi: 10.3389/fendo.2024.1430693. eCollection 2024.
To explore the impact of lymph node diameter on the efficacy and safety of ultrasound-guided microwave ablation (MWA) in the treatment of cervical metastatic lymph nodes (CMLNs) from thyroid cancer.
A total of 32 patients with 58 CMLNs from thyroid cancer underwent ultrasound-guided MWA and were included in the retrospective study. Patients were divided into three groups based on the mean largest diameter of the CMLNs: Group A (diameter ≤10mm), Group B (10mm < diameter ≤20mm), and Group C (diameter >20mm). The research involved comparing changes in cervical metastatic lymph nodes and serum thyroglobulin (sTg) levels, as well as the incidence of complications, before and after microwave ablation across three groups of patients.
The technical success rate of this study was 100% (32/32), and they showed no major complications. Compared with measurements taken before MWA, the mean largest diameter and volume of CMLNs, as well as the sTg level, showed significant reductions (0.05) at the last follow-up in all three patient groups. Group A and B exhibited higher lymph node volume reduction rates and complete disappearance rates compared to Group C. However, the recurrence rate in the three groups were in the following order: Group C > Group B > Group A. The occurrence rate of mild complications was Group A > Group C > Group B.
MWA is a safe and effective method for treating CMLNs, with advantages for localized nodes but limitations for larger ones. Careful consideration and personalized plans are advised, based on comprehensive evidence assessment.
探讨淋巴结直径对超声引导下微波消融（MWA）治疗甲状腺癌颈转移性淋巴结（CMLNs）疗效和安全性的影响。
回顾性分析 32 例 58 个甲状腺癌 CMLNs 患者行超声引导下 MWA 的临床资料，根据 CMLNs 最大径的平均值将患者分为三组：A 组（直径≤10mm）、B 组（10mm＜直径≤20mm）和 C 组（直径＞20mm）。比较三组患者微波消融前后颈转移性淋巴结及血清甲状腺球蛋白（sTg）水平的变化及并发症的发生率。
本研究技术成功率为 100%（32/32），无严重并发症发生。与 MWA 前相比，三组患者的 CMLNs 最大径及体积、sTg 水平在末次随访时均明显减小（0.05）。A 组和 B 组的淋巴结体积缩小率和完全消失率均高于 C 组，但三组的复发率依次为 C 组＞B 组＞A 组。三组患者中轻度并发症的发生率依次为 A 组＞C 组＞B 组。
MWA 是治疗 CMLNs 的一种安全有效的方法，对于局限性淋巴结具有优势，但对于较大的淋巴结存在局限性。应根据综合证据评估，慎重考虑并制定个体化方案。
