热消融治疗甲状腺乳头状癌的有效性评估

目的通过对甲状腺乳头状癌（PTC）热消融后复发再手术病例进行分析，探讨热消融是否能用于可手术的PTC患者。 方法回顾性分析2015年5月至2019年8月间青岛大学附属烟台毓璜顶医院甲状腺外科热消融治疗后再手术的23例患者资料。所有患者在外院行热消融治疗前均行甲状腺细针穿刺（FNA），20例穿刺病理为PTC，3例不除外PTC可能。15例行甲状腺癌根治术，1例行侧颈部淋巴结改良根治术，7例患者因存在复发结节压迫症状，行甲状腺腺叶切除术。 结果再手术后石蜡病理示，56.52%（13/23）见癌细胞，43.47%（10/23）未查见癌细胞，30.43%（7/23）见中央区淋巴结转移。2例消融对侧发现新发甲状腺结节，术后石蜡病理证实为PTC。 结论热消融治疗PTC无法彻底处理原发灶，达不到根治效果。对于可行手术治疗的PTC患者，不建议热消融治疗。

Evaluation of efficacy of thermal ablation in the treatment of papilary thyroid carcinoma

ObjectiveTo investigate whether thermal ablation can be used in operable papillary thyroid carcinoma (PTC) patients by analyzing the recurrence and reoperation cases of PTC after thermal ablation. MethodsThe data of twenty-three patients undergoing surgery after thermal ablation in Yuhuangding Hospital of Medical College of Qingdao University were retrospectively analyzed from May 2015 to August 2019. Fine needle aspiration (FNA) was performed in all patients before thermal ablation treatment in other hospitals, twenty cases were diagnosed as PTC and three cases was not excluded after biopsy. Fifteen cases underwent radical thyroidectomy, one underwent modified radical resection of lateral cervical lymph nodes, and seven cases underwent lobectomy due to compression of recurrent nodules. ResultsThe pathology of paraffin after reoperation showed that 56.52% (13/23) had cancer cells, 43.47% (10/23) had no cancer cells, and 30.43% (7/23) had central lymph node metastasis. New PTC nodules were found on the opposite side of ablation in two cases. ConclusionsThermal ablation of PTC can’t completely deal with the primary lesions or achieve a radical effect. Thermal ablation is not recommended for PTC patients for whom surgical treatment is feasible.