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甲状腺乳头状癌热消融术后预防肿瘤复发的当前证据与策略

Current evidence and strategies for preventing tumor recurrence following thermal ablation of papillary thyroid carcinoma.

作者信息

Li Ru, Yang Luyang, Xu Ming, Wu Baofeng, Liu Qinhao, An Qin, Sun Yuchen, Zhang Yi, Liu Yunfeng

机构信息

Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China.

First Clinical Medical College, Shanxi Medical University, Taiyuan, China.

出版信息

Cancer Imaging. 2025 Jul 9;25(1):88. doi: 10.1186/s40644-025-00908-7.

Abstract

BACKGROUND

The incidence of papillary thyroid carcinoma (PTC) has been increasing, and thermal ablation has emerged as a minimally invasive alternative to surgery for low-risk cases. However, post-ablation tumor progression remains a significant clinical challenge.

METHODS

This review synthesizes existing literature on tumor progression after thermal ablation for PTC, analyzing potential causes and evaluating preventive strategies at different diagnostic and treatment stages.

RESULTS

Current research reports indicate that the probability of disease progression following thermal ablation for PTMC ranges from 1.25 to 7.7%, a rate comparable to that of surgical management. Nodules exceeding 10 mm in diameter are associated with a higher risk of post-procedural progression. However, pathological evidence supporting these findings remains limited. Risk factors such as suboptimal patient selection and tumor proximity to critical structures further influence outcomes. Improved imaging guidance, standardized protocols, and stringent follow-up may reduce these complications.

CONCLUSION

When these recommendations are followed, thermal ablation for PTMC achieves effective reduction in tumor progression risk and represents a viable alternative for appropriately selected patients. However, expansion of its indications requires further robust evidence from large-scale, pathology-based studies.

摘要

背景

甲状腺乳头状癌(PTC)的发病率一直在上升,热消融已成为低风险病例手术的一种微创替代方法。然而,消融后肿瘤进展仍然是一个重大的临床挑战。

方法

本综述综合了关于PTC热消融后肿瘤进展的现有文献,分析了潜在原因,并评估了不同诊断和治疗阶段的预防策略。

结果

目前的研究报告表明,PTMC热消融后疾病进展的概率为1.25%至7.7%,这一比率与手术治疗相当。直径超过10毫米的结节术后进展风险较高。然而,支持这些发现的病理证据仍然有限。患者选择不当和肿瘤靠近关键结构等风险因素进一步影响治疗结果。改进的影像引导、标准化方案和严格的随访可能会减少这些并发症。

结论

遵循这些建议时,PTMC热消融可有效降低肿瘤进展风险,是适合患者的可行替代方案。然而,扩大其适应证需要来自大规模、基于病理的研究的更有力证据。

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