Efficacy and safety of microwave ablation for cervical metastatic lymph nodes arising post resection of papillary thyroid carcinoma: a retrospective study
Efficacy and safety of microwave ablation for cervical metastatic lymph nodes arising post resection of papillary thyroid carcinoma: a retrospective study
复制标题
DOI：
10.1080/02656736.2020.1759829
复制
发表时间：
2020-01-01
影响因子：
3.1
通讯作者：
Yu, Ming-An
中科院分区：
文献类型：
--
作者：
Cao, Xiao-Jing;Wei, Ying;Yu, Ming-An
目的：评价微波消融（MWA）治疗甲状腺乳头状癌（PTC）术后颈部转移淋巴结（LNs）的疗效和安全性。材料与方法：2015年11月至2018年11月，回顾性研究14例38例经MWA治疗的宫颈转移性LNs。采用Wilcoxon符号秩检验比较消融前后LN和血清甲状腺球蛋白水平的变化。结果：本研究技术成功率为100%（38/38）。平均随访时间23.6±9.3个月。消融前超声造影显示高增强25个LNs，等增强8个LNs，低增强5个LNs。消融前和消融后3、6、9、12、18、24和36个月的中位最大直径分别为11.5 mm和9.5、9.0、8.0、8.0、8.0、7.0和6.0 mm。消融前和消融后3、6、9、12、18、24和36个月的中位体积分别为251.2 mm(3)和206.7、167.2、166.2、155.7、153.9、153.9和113.1 mm(3)。最后一次消融后宫颈转移灶的最大直径和体积均明显小于消融前（p = 0.0016; p = 0.0018）。最后一次消融后血清Tg水平（中位数1.25 ng/mL）显著低于消融前水平（中位数8.35 ng/mL） （p = .001）。没有并发症。结论：MWA是一种安全有效的治疗PTC术后颈部转移性LN的新方法。
Purpose: To evaluate the efficacy and safety of microwave ablation (MWA) for cervical metastatic lymph nodes (LNs) post resection of papillary thyroid cancer (PTC). Materials and methods: From November 2015 to November 2018, 14 patients with 38 cervical metastatic LNs treated by MWA were included in this retrospective study. Wilcoxon signed rank test was used to compare the changes of LN and serum thyroglobulin levels pre- and post-ablation. Results: The technical success rate in this study was 100% (38/38). The mean follow-up time was 23.6 +/- 9.3 months. On pre-ablation contrast-enhanced ultrasound, 25 LNs showed high-enhancement, 8 LNs showed iso-enhancement, and 5 LNs showed low-enhancement. The median largest diameter of LNs at pre-ablation and 3, 6, 9, 12, 18, 24, and 36 months post-ablation was 11.5 mm and 9.5, 9.0, 8.0, 8.0, 8.0, 7.0, and 6.0 mm, respectively. The median volume of LNs at pre-ablation and 3, 6, 9, 12, 18, 24, and 36 months post-ablation were 251.2 mm(3) and 206.7, 167.2, 166.2, 155.7, 153.9, 153.9, and 113.1 mm(3), respectively. The largest diameter and the volume of the cervical metastatic LNs at the last post-ablation was significantly smaller than the pre-ablation level (p = .0016; p = .0018). Serum Tg level at the last post-ablation (median 1.25 ng/mL) was significantly lower than the pre-ablation level (median 8.35 ng/mL) (p = .001). There were no complications. Conclusion: MWA is a safe and effective novel treatment option for cervical metastatic LN that emerge post resection of PTC.