[1]顾美琴,奚 静,李 尊,等.超声引导下微波消融治疗多灶性T1N0M0甲状腺乳头状癌的可行性研究[J].介入放射学杂志,2024,33(05):495-499.
 GU Meiqin,XI Jing,LI Zun,et al.Ultrasound- guided microwave ablation for multifocal T1N0M0 papillary thyroid carcinoma: a feasibility study[J].journal interventional radiology,2024,33(05):495-499.
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超声引导下微波消融治疗多灶性T1N0M0甲状腺乳头状癌的可行性研究()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年05
页码:
495-499
栏目:
非血管介入
出版日期:
2024-06-03

文章信息/Info

Title:
Ultrasound- guided microwave ablation for multifocal T1N0M0 papillary thyroid carcinoma: a feasibility study
作者:
顾美琴 奚 静 李 尊 钱 丰
Author(s):
GU Meiqin XI Jing LI Zun QIAN Feng.
Department of Ultrasound, Affiliated Wujin Hospital of Jiangsu University (Wujin Clinical College of Xuzhou Medical University), Changzhou, Jiangsu Province 213000, China
关键词:
【关键词】 超声微波消融甲状腺乳头状癌肿瘤最大直径甲状腺激素
文献标志码:
A
摘要:
【摘要】 目的 研究超声引导下微波消融治疗多灶性T1N0M0甲状腺乳头状癌(PTC)的可行性、安全性和有效性。方法 随机纳入2019年1月至2022年1月我院确诊多灶性T1N0M0(≤3个)PTC患者68例为研究对象,肿瘤最大直径≤2 cm,均采用超声引导下微波消融治疗。随访至2023年4月,中位时间为30个月,随访包括常规超声、超声造影、甲状腺功能及必要的细针穿刺细胞学检查(FNA)。结果 68例患者分为T1a组52例和T1b组16例,T1b组消融时间显著延长,肿瘤最大直径增加,差异有统计学意义(P<0.05)。68例患者均成功完成手术并康复出院,无明显并发症,超声造影显示消融淋巴结无增强。消融术后1、3、6个月肿瘤最大直径和体积显著大于术前(P<0.05),术后12、18、24个月均逐渐缩小(P<0.05)。随访未出现肿瘤进展或者复发。术前与末次随访甲状腺功能包括甲状腺球蛋白、总甲状腺素和促甲状腺素水平均无显著变化(P>0.05)。结论 超声引导下微波消融治疗多灶性T1N0M0的PTC患者有较好的可行性、安全性和有效性。
【关键词】 超声;微波消融;甲状腺乳头状癌;肿瘤最大直径;甲状腺激素

参考文献/References:

[1] Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J]. CA Cancer J Clin, 2021, 71: 7- 33.
[2] 董小娟,张德言,刘 洋. 多灶性甲状腺乳头状癌的临床病理特征及中央区淋巴结转移危险因素分析[J]. 医学理论与实践, 2023, 36:556- 558.
[3] Wang TS,Sosa JA. Thyroid surgery for differentiated thyroid cancer: recent advances and future directions[J]. Nat Rev Endocrinol, 2018, 14: 670- 683.
[4] Crocetti L,Scalise P,Bozzi E,et al. Microwave ablation of very- early- and early- stage HCC: efficacy evaluation by correlation with histology after liver transplantation[J]. Cancers(Basel), 2021, 13: 3420.
[5] Xiao J, Zhang Y, Zhang M, et al. Ultrasonography- guided radiofrequency ablation vs. surgery for the treatment of solitary T1bN0M0 papillary thyroid carcinoma: a comparative study[J]. Clin Endocrinol (Oxf), 2021, 94: 684- 691.
[6] Cao XJ,Wang SR,Che Y,et al. Efficacy and safety of thermal ablation for treatment of solitary T1N0M0 papillary thyroid carcinoma: a multicenter retrospective study[J]. Radiology, 2021, 300: 209- 216.
[7] Cao XJ,Liu J,Zhu YL,et al. Efficacy and safety of thermal ablation for solitary T1bN0M0 papillary thyroid carcinoma: a multicenter study[J]. J Clin Endocrinol Metab, 2021, 106: e573- e581.
[8] Wu J, Zhao ZL, Cao XJ, et al. A feasibility study of microwave ablation for papillary thyroid cancer close to the thyroid capsule[J]. Int J Hyperthermia, 2021, 38: 1217- 1224.
[9] Choi Y,Jung SL. Efficacy and safety of thermal ablation techniques for the treatment of primary papillary thyroid microcarcinoma: a systematic review and meta- analysis[J]. Thyroid, 2020, 30: 720- 731.
[10] 邱 贝,赵 波,王 涛,等. 基于倾向评分匹配分析甲状腺乳头状癌多灶性对不良预后的影响[J]. 中华医学杂志, 2019, 99: 2332- 2336.
[11] del RP,Loderer T,Giuffrida M,et al. Multifocality in patients treated for papillary thyroid carcinoma: a preliminary analysis of related risk factors[J]. Acta Biomed, 2021,92: e2021017.
[12] Kim H,Kwon H,Moon BI. Association of multifocality with prognosis of papillary thyroid carcinoma: a systematic review and meta- analysis[J]. JAMA Otolaryngol Head Neck Surg, 2021, 147: 847- 854.
[13] 费建平,刘宏伟. 甲状腺乳头状癌喉返神经深层面淋巴结转移的影响因素分析[J]. 临床外科杂志, 2023, 31:57- 59.
[14] Cui L,Feng D,Zhu C,et al. Clinical outcomes of multifocal papillary thyroid cancer:a systematic review and meta- analysis[J]. Laryngoscope Investig Otolaryngol, 2022, 7: 1224- 1234.
[15] Ghai S, O’Brien C, Goldstein DP, et al. Ultrasound in active surveillance for low- risk papillary thyroid cancer: imaging considerations in case selection and disease surveillance[J]. Insights Imaging, 2021, 12: 130.
[16] Tamai H,Okamura J. New next- generation microwave thermosphere ablation for small hepatocellular carcinoma[J]. Clin Mol Hepatol, 2021, 27: 564- 574.
[17] 梁金屏,张宏伟,石福民. 甲状腺乳头状癌患者应用微波消融术治疗中体重指数对甲状腺功能的影响及复发危险因素分析[J]. 中国临床医生杂志, 2022, 50:946- 949.
[18] Cao XJ, Zhao ZL, Wei Y, et al. Microwave ablation for papillary thyroid cancer located in the thyroid isthmus: a preliminary study[J]. Int J Hyperthermia, 2021, 38: 114- 119.
[19] Cao XJ,Wang SR,Che Y,et al. Efficacy and aafety of thermal ablation for treatment of solitary T1N0M0 papillary thyroid carcinoma: a multicenter retrospective study[J]. Radiology, 2021, 300: 209- 216.
[20] Ding M, Wu GS, Gu JH, et al. Pathology confirmation of the efficacy and safety of microwave ablation in papillary thyroid carcinoma[J]. Front Endocrinol(Lausanne), 2022, 13: 929651.
[21] Mauri G,Hegedüs L,Bandula S,et al. European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 clinical practice guideline for the use of minimally invasive treatments in malignant thyroid lesions[J]. Eur Thyroid J, 2021, 10: 185- 197.
[22] Cao XJ, Zhao ZL, Wei Y, et al. Microwave ablation for papillary thyroid cancer located in the thyroid isthmus: a preliminary study[J]. Int J Hyperthermia, 2021, 38: 114- 119.
[23] Xiao J, Zhang Y, Yan L, et al. Ultrasonography- guided radiofrequency ablation for solitary T1aN0M0 and T1bN0M0 papillary thyroid carcinoma: a retrospective comparative study[J]. Eur J Endocrinol, 2021, 186: 105- 113.
[24] Wei Y,Niu WQ,Zhao ZL, et al. Microwave ablation versus surgical resection for solitary T1N0M0 papillary thyroid carcinoma[J]. Radiology, 2022, 304: 704- 713.
[25] 朱乔丹,王立平,徐 栋. 超声引导下热消融治疗甲状腺乳头状癌术后颈部转移性淋巴结的疗效分析[J]. 介入放射学杂志, 2021, 30:390- 393.
[26] Lyu YS, Pyo JS, Cho WJ, et al. Clinicopathological significance of papillary thyroid carcinoma located in the isthmus: a meta- analysis[J]. World J Surg, 2021, 45: 2759- 2768.
[27] Tang W,Sun W,Niu X,et al. Evaluating the safety and efficacy of microwave ablation in treatment of cervical metastatic lymph nodes of papillary thyroid carcinoma compared to repeat surgery[J]. Int J Hyperthermia, 2022, 39: 813- 821.
[28] 李昕莹,薛 杰,陈黄卓楠,等. 多模态超声及术前BRAF基因预测甲状腺微小乳头状癌颈部淋巴结转移的价值[J]. 现代肿瘤医学, 2023, 31:1696- 1701.
[29] 王开银,林 凯,宋 彬,等. 甲状腺乳头状癌患者甲状腺肿瘤特征对颈侧区淋巴结转移的影响[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28:73- 76.
[30] Yan L,Zhang M,Song Q,et al. Clinical outcomes of radiofrequency ablation for multifocal papillary thyroid microcarcinoma versus unifocal papillary thyroid microcarcinoma: a propensity- matched cohort study[J]. Eur Radiol, 2022, 32: 1216- 1226.
[31] Yue W, Wang S, Xu H. Thermal ablation for papillary thyroid microcarcinoma: some clarity amid controversies[J]. J Interv Med, 2022, 5: 171- 172.

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备注/Memo

备注/Memo:
(收稿日期:2023- 05- 16)
(本文编辑:茹 实)
更新日期/Last Update: 2024-06-03