Microwave Ablation Compared With Laser Ablation for Treating Benign Thyroid Nodules in a Propensity-Score Matching Study
Microwave Ablation Compared With Laser Ablation for Treating Benign Thyroid Nodules in a Propensity-Score Matching Study
复制标题
DOI：
10.3389/fendo.2019.00874
复制
发表时间：
2019-12-13
影响因子：
5.2
通讯作者：
Liang, Yong-Ping
中科院分区：
文献类型：
--
作者：
Shi, Yi-Fan;Zhou, Ping;Liang, Yong-Ping
目的：回顾性比较经皮超声引导微波和激光消融（分别为MWA和LA）治疗良性甲状腺结节（BTN）的疗效和安全性。方法：患者 (n = 318) 接受了 328 个 BTN 的消融。通过倾向评分匹配减少了混杂偏差，最终 MWA 组和 LA 组各包含 160 个结节。在基线（消融前）、第 3、6 和 12 个月以及此后每 6 个月记录以下数据：结节体积减少率 (VRR)、颈部症状评分、美容评分、并发症和副作用。结果：MWA 组和 LA 组的基线特征具有可比性。相对于基线，所有随访期间所有结节的体积均较小，术后 6 个月及此后的症状和美容评分也较小 (P < 0.01)。在每次随访中，MWA 组和 LA 组的总体 VRR 具有可比性。然而，对于> = 13 mL的结节，> = 6个月时与LA相关的VRR显着大于MWA。 MWA 的平均消融时间短于 LA（P < 0.01）。主要并发症、次要并发症和副作用的总体发生率分别为1.6%、2.2%和18.4%，MWA组和LA组之间没有显着差异。结论：经皮超声引导MWA和LA治疗BTNs均安全有效。每一种都能显着缩小结节体积，改善患者颈部症状和外观，且不良副作用发生率低。 MWA 的效率高于 LA。对于 >= 13 mL 的结节，MWA 可能是首选，但在 6 个月及后续随访中，接受 LA 的患者体积减少幅度更大。
Objective: The efficacy and safety of percutaneous ultrasound-guided microwave and laser ablation (MWA and LA, respectively), for treating benign thyroid nodules (BTNs), were retrospectively compared. Methods: Patients (n = 318) underwent ablation of 328 BTNs. Confounding bias was reduced by propensity-score matching, and finally the MWA and LA groups each comprised 160 nodules. At baseline (before ablation), 3, 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule volume reduction rate (VRR), neck symptom scores, cosmetic scores, complications, and side effects. Results: The baseline characteristics of the MWA and LA groups were comparable. The volumes of all nodules were less at all follow-ups relative to the baseline, as were the symptom and cosmetic scores at postoperative 6 months and thereafter (P < 0.01). At each follow-up, the overall VRRs of the MWA and LA groups were comparable. However, for nodules >= 13 mL, the VRR associated with LA at >= 6 months was significantly greater than that of MWA. The average ablation time for MWA was less than that of LA (P < 0.01). The overall incidences of major complications, minor complications, and side effects were 1.6, 2.2, and 18.4%, respectively, and there were no significant differences between the MWA and LA groups. Conclusion: Percutaneous ultrasound-guided MWA and LA are both safe and effective for the treatment of BTNs. Each can significantly reduce the nodule volume and improve the neck symptoms and appearance of patients, with a low incidence of adverse side effects. The efficiency of MWA is higher than that of LA. For nodules >= 13 mL, MWA may be preferred, but at 6 months and subsequent follow-ups the reduction in volume was greater in patients receiving LA.