Limei Lai, Chun Zhou, Zhenhua Liu, Jingwen Zhang, Xiaofeng Ni, Juan Liu, Ning Li, Shujun Xia, Yijie Dong, Jianqiao Zhou
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引用次数: 0
Abstract
Purpose: To assess the impact of Hashimoto's thyroiditis (HT) on radiofrequency ablation (RFA) outcomes for papillary thyroid microcarcinoma (PTMC).
Methods: A retrospective study of 391 PTMC patients treated with RFA from March 2017 to August 2020, divided by HT accompanied or not. Ablation area size, volume reduction ratio (VRR), lesion disappearance, complications, and recurrences were analyzed.
Results: 391 patients (mean age, 41.3 ± 11.2 [SD]; 317 women, 110 with HT) were evaluated. The follow-up time was 2 years. HT+ PTMC patients (Group A) exhibited larger ablation diameters at 1st and 3rd month post-RFA. In comparison, PTMC patients (Group B) had larger diameters at 1st and 3rd months but smaller at 6th months, returning to baseline around 6th month in Group B and 9th month in Group A. VRRs in Group B were greater than Group A at 3rd, 6th, 9th, 12th and 15th month, all p < 0.05). The Kaplan-Meier curves revealed a slower lesion disappearance rate in A (12th) compared to B group (9th). Complication and recurrence rates were similar for both groups (4.4% and 0.8% overall, Group B vs Group A: 4.3% vs 4.6%, p = 0.905; 0.4% vs 1.8%, p = 0.192).
Conclusion: HT delays the resorption of PTMC lesions following RFA, but it does not impact the procedure's effectiveness or safety. Regardless of HT status, RFA remains a viable alternative to surgery for PTMC.
目的：评估桥本甲状腺炎（HT）对甲状腺乳头状微癌（PTMC）射频消融（RFA）结果的影响。方法：回顾性分析2017年3月至2020年8月391例PTMC患者接受RFA治疗，分为是否伴有HT。分析消融面积、体积缩小率（VRR）、病灶消失、并发症及复发率。结果：391例患者(平均年龄41.3±11.2 [SD]；317名妇女（其中110名患有HT）接受了评估。随访时间2年。HT+ PTMC患者（A组）在rfa后1个月和3个月表现出较大的消融直径。相比之下，PTMC患者（B组）在第1和第3个月时直径较大，但在第6个月时直径较小，B组在第6个月左右恢复到基线，A组在第9个月左右恢复到基线。B组在第3、6、9、12和15个月的vrr大于A组，所有p Kaplan-Meier曲线显示A组（第12）的病变消失率比B组（第9）慢。两组的并发症和复发率相似（4.4%和0.8%），B组vs A组：4.3% vs 4.6%, p = 0.905；0.4% vs 1.8%, p = 0.192)。结论：热疗延迟了RFA后PTMC病变的吸收，但不影响手术的有效性和安全性。无论HT状态如何，RFA仍然是PTMC手术的可行选择。
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