微波消融治疗甲状腺乳头状癌术后淋巴结转移的临床研究和疗效观察  

Clinical study and efficacy observation of microwave ablation in the treatment of lymph node metastasis after papillary thyroid carcinoma surgery

作　　者：付强 李威[1] 满文玲 李伟[1] 杨坡[1] FU Qiang;LI Wei;MAN Wenling;LI Wei;YANG Po(Department of Intervention Vascular Surgery,The Fourth Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院介入血管外科,哈尔滨150001

出　　处：《实用肿瘤学杂志》2020年第5期436-439,共4页Practical Oncology Journal

基　　金：黑龙江省自然科学基金(编号:H2015090)。

摘　　要：目的为了提高对超声引导下经皮微波消融术治疗甲状腺乳头状癌术后颈部淋巴结转移癌的认识,并评价其疗效性和安全性。方法选择84例甲状腺乳头状癌术后复发的患者,接受微波消融治疗后,通过超声造影增强检查,评估消融区内的肿瘤活性,在1、3、6个月以及12个月对患者进行肿瘤大小、体积和血清甲状腺球蛋白的测量临床评估。结果103个颈部淋巴结转移癌全部成功接受了微波消融治疗,治疗后超声造影增强检查未检测到不完全消融,在最后一次随访中,平均最大直径从10.5±5.7 mm减小到0.8±1.5 mm(P<0.05),平均体积从285.9±245.7 mm3减小到4.0±8.0 mm3(P<0.05)。治疗后既未检测到已治疗的肿瘤发生进展,也没有新增可疑的淋巴结。结论超声引导下经皮微波消融术可能成为某些不适合或拒绝进行手术治疗的甲状腺乳头状癌术后淋巴结转移患者的替代疗法,这种手术安全有效,并发症发生率低。Objective The aims of this study were to improve the understanding of ultrasound-guided percutaneous microwave ablation for cervical lymph node metastasis after papillary thyroid carcinoma surgery,and to evaluate its efficacy and safety.Methods A study of 84 patients with postoperative recurrent papillary thyroid carcinoma was selected.After receiving microwave ablation,ultrasound contrast enhancement examination was performed to assess tumor activity in the ablation zone.The patient′s tumor size,volume,serum thyroglobulin and clinical evaluation were carried out in 1,3 and 6 months,and 12 months thereafter.Results A total of 103 patients with cervical lymph node metastases were successfully treated by microwave ablation.After treatment,ultrasound contrast enhancement examination did not detect incomplete ablation.During the last follow-up,the average maximum diameter decreased from 10.5±5.7 mm to 0.8±1.5 mm(P<0.05),and the average volume was reduced from 285.9±245.7 mm3 to 4.0±8.0 mm3(P<0.05).After the treatment,neither the progression of the treated tumor was detected nor the suspicious lymph nodes added.Conclusion Ultrasound-guided percutaneous microwave ablation may become an alternative therapy for thyroid papillary carcinoma patients with lymph node metastasis who are not suitable or refuse to undergo surgical treatment.This operation is safe and effective,and the incidence of complications is low.

关 键 词：甲状腺乳头状癌 淋巴结转移 微波消融术 

分 类 号：R454.5[医药卫生—治疗学]