Effect of chronic lymphocytic thyroiditis on the efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma
Effect of chronic lymphocytic thyroiditis on the efficacy and safety of ultrasound-guided radiofrequency ablation for papillary thyroid microcarcinoma
复制标题
慢性淋巴细胞性甲状腺炎对超声引导下甲状腺微小乳头状射频消融术疗效及安全性的影响
DOI：
10.1002/cam4.2406
复制
发表时间：
2019-07-30
期刊：
影响因子：
4
通讯作者：
Tang, Jie
中科院分区：
文献类型：
--
作者：
Zhang, Yan;Zhang, Ming-bo;Tang, Jie
背景慢性淋巴细胞性甲状腺炎(CLT)是一种自身免疫性疾病，常与甲状腺乳头状癌相关，临床表现为原发肿瘤体积较小。超声引导下射频消融术(RFA)治疗合并CLT的甲状腺微小乳头状癌(PTMC)的疗效和安全性尚不清楚。方法将60例单灶性PTMC患者分为PTMC组和PTMC+CLT组，每组30例。组织病理学诊断为CLT。消融范围超过肿瘤边缘，经超声和超声造影评价肿瘤残留情况，以防止复发。消融三个月后，在超声引导下进行核心针活检，以评估残留和复发癌症的存在。记录患者和肿瘤患者的术前、术后数据，并进行分析。结果两组患者在年龄、性别、术前肿瘤体积、消融时间、消融功率等方面差异无统计学意义(P>；0.05)。术后1个月、3个月、6个月、12个月和18个月随访时，两组间消融区体积也没有显著差异(P>；0.05)。3个月时两组间的体积缩小率差异有统计学意义(P=0.03)。PTMC组和PTMC+CLT组分别在9.8+/-5.0月和10.0+/-4.8月未能在超声和CEUS上显示消融区域(P=0.197)。术中、术后均未发生严重并发症。消融后活检未发现残留癌细胞。结论射频消融治疗PTMC+CLT有效，其疗效和安全性与PTMC非CLT患者相似。
Background Chronic lymphocytic thyroiditis (CLT) is an autoimmune disease commonly associated with papillary thyroid carcinoma characterized by a smaller primary tumor size at presentation. The efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) coexisting with CLT is still unknown. Methods Sixty patients with unifocal PTMC were enrolled and classified into PTMC and PTMC+CLT groups (n = 30/group). CLT was diagnosed histopathologically. The ablation area exceeded the tumor margins, and was evaluated by US and contrast-enhanced US (CEUS) for residual tumor to prevent recurrence. Three months after ablation, US-guided core-needle biopsy was performed to assess the presence of residual and recurrent cancer. Preoperative and postoperative data on patients and tumors were recorded and analyzed. Results There were no differences between groups in age, sex, preoperative tumor volume, ablation time, or ablation power (P > 0.05). There was also no significant difference in postoperative ablation zone volume between the groups at the 1-, 3-, 6-, 12-, and 18-month follow-ups (P > 0.05). The volume reduction rate significantly differed between the two groups at month 3 (P = 0.03). The ablation area could not be identified on US and CEUS at 9.8 +/- 5.0 and 10.0 +/- 4.8 months in the PTMC and PTMC + CLT groups, respectively (P = 0.197). No serious complications occurred during and after ablation. No residual cancer cells were found on biopsy after ablation. Conclusions RFA was effective in patients with PTMC+CLT, and its therapeutic efficacy and safety were similar to those in patients with PTMC without CLT.