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激光消融与微波消融治疗甲状腺微小乳头状癌的疗效与安全性:一项回顾性研究。

Efficacy and safety of laser ablation and microwave ablation to treat papillary thyroid microcarcinoma: A retrospective study.

作者信息

Huang Yuqing, Zhao Xinyu, Yang Yu, Qiu Lanyan, Zhao Junfeng, Qian Linxue, Shi Xianquan

机构信息

Department of Ultrasound, Capital Medical University Beijing Friendship Hospital, Beijing 100050, China; Department of Ultrasound, Aerospace Center Hospital, Beijing 100049, China.

Clinical Epidemiology and EBM Unit, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, 100050, China.

出版信息

Am J Otolaryngol. 2024 Nov-Dec;45(6):104496. doi: 10.1016/j.amjoto.2024.104496. Epub 2024 Aug 14.

Abstract

OBJECTIVE

To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC).

METHODS

This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed.

RESULTS

Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, P < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (P = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (P > 0.05).

CONCLUSION

During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.

摘要

目的

回顾性分析激光消融(LA)和微波消融(MWA)治疗甲状腺微小乳头状癌(PTMC)的疗效和安全性。

方法

这是一项对2019年10月至2023年3月期间接受热消融治疗PTMC的103例患者(109个结节)的回顾性研究;61例行LA,48例行MWA。患者平均年龄为43.50±12.42岁。消融后,评估并记录不同时间点肿瘤大小的变化、局部复发、新发病变、淋巴结转移及并发症情况。分析LA和MWA的可行性、成功率及安全性。

结果

消融后所有靶肿瘤在超声造影上均表现为完全无强化。末次随访时,PTMC结节平均体积从0.09±0.09降至0.03±0.03 ml(LA组),从0.11±0.10降至0.06±0.08 ml(MWA组)(均P<0.05)。两组间体积变化无显著差异(组间P:0.520;组间随时间变化P:0.423),表明两组疗效相似。随访期间,除3个月时外,两组间体积缩小率无显著差异(P=0.023)。LA组并发症发生率为8.2%,MWA组为6.3%,两组间无显著差异(P>0.05)。

结论

在短期随访中,超声引导下的LA和MWA治疗PTMC有效且安全,两种方法的治疗效果无显著差异。

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