超声引导下微波消融治疗甲状腺乳头状癌颈部转移性淋巴结的价值分析

目的 探讨超声引导下微波消融治疗甲状腺乳头状癌颈部转移性淋巴结的安全性及有效性。方法 回顾性分析2017年7月至2020年10月于我院行微波消融治疗的20例甲状腺乳头状癌颈部转移性淋巴结患者,共36枚淋巴结。比较微波消融前后病灶最大径、体积、体积缩小率及血清Tg等生化指标的改变,分析不同消融功率对病灶最大径、体积及体积缩小率的影响。结果 20例患者均成功接受微波消融治疗,整个消融过程未见明显严重并发症,消融术后1例患者出现低钙血症,但于术后1周恢复正常。微波消融术后1个月病灶最大径、体积较消融前略增大,差异无统计学意义(P＞0.05)。在随后的3,6,12,18及24个月时病灶最大径、体积均较术前显著减小,差异均具有统计学意义(P＜0.05)。微波消融术后血清Tg水平较消融前降低,差异具有统计学意义(P＜0.05)。不同消融功率下病灶最大径、体积及体积缩小率均未见明显差异(P＞0.05)。结论 超声引导下微波消融治疗甲状腺乳头状癌颈部转移性淋巴结安全、有效,对手术风险较大及拒绝手术治疗的患者不失为一种良好的替代治疗方法。

The value analysis of ultrasound-guided microwave ablation for cervical metastatic lymph nodes from papillary thyroid carcinoma

Objective To investigate the safety and efficacy of ultrasound-guided microwave ablation (MWA) for cervical metastatic lymph nodes (LNMs) from papillary thyroid carcinoma (PTC). Methods From July 2017 to October 2020, 20 patients with LNMs from PTC treated by MWA were enrolled in our study. The changes of the largest diameter, volume, volume reduction ratio (VRR) and serum Tg pre- and post-ablation were compared, and the effects of different ablation powers on the largest diameter, volume and VRR were analyzed. Results All the patients were successfully treated with MWA, and no obvious serious complications were observed during the whole ablation process. One patient developed hypocalcemia after ablation, but returned to normal within 1 week. The largest diameter and volume increased slightly at 1-month follow-up compared with pre-ablation, but the differences were not statistically significant (P > 0.05). At the subsequent 3,6,12,18,24 months and the last follow-up, the largest diameter and volume were significantly reduced compared with pre-ablation (P < 0.05). The serum Tg level after ablation was lower than that before ablation, and the difference was statistically significant (P < 0.05). There were no significant differences in the largest diameter, volume and VRR under different ablation powers (P > 0.05). Conclusion Ultrasound-guided microwave ablation is safe and effective in the treatment of LNMs from PTC. It could be regarded as a good alternative for patients with high surgical risk and those who refuse repeat surgery.