微波消融与手术切除治疗孤立性T1N0M0期甲状腺乳头状癌  

Microwave ablation and surgical resection in treatment of solitary T1N0M0 papillary thyroid carcinoma

作　　者：魏莹[1] 杨猛[2] 赵朕龙 彭丽丽[1] 李妍[1] 卢乃聪 伍洁 于明安[1] WEI Ying;YANG Meng;ZHAO Zhenlong;PENG Lili;LI Yan;LU Naicong;WU Jie;YU Ming'an(Department of Interventional Medicine,China-Japan Friendship Hospital,Beijing 100029,China;Department of General Surgery,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院介入医学科,北京100029 [2]中日友好医院普通外科,北京100029

出　　处：《中国介入影像与治疗学》2023年第2期65-69,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家自然科学基金项目(62176268)。

摘　　要：目的观察微波消融(MWA)与手术切除(SR)治疗孤立性T1N0M0期甲状腺乳头状癌(PTC)的价值。方法纳入接受MWA(MWA组,n=364)或SR(SR组,n=364)治疗的728例孤立性T1N0M0期PTC患者,比较组间治疗相关及术后随访资料,对比MWA与SR疗效。结果MWA组与SR组手术时间分别为23(14,38)min及72(33,180)min,术中失血量为2(1,5)ml及10(8,30)ml,术后住院时间为1(1,3)天及2(1,6)天,差异均有统计学意义(P均<0.01)。MWA组16例疾病进展,包括局部复发1例、新发PTC 12例及颈部淋巴结转移3例;SR组15例疾病进展,包括新发PTC 11例及颈部淋巴结转移4例;组间疾病进展差异均无统计学意义(P均>0.05)。并发症发生率组间差异无统计学意义(χ^(2)=-3.36,P>0.99)。至随访期末,MWA组T1期PTC肿瘤缩小率为89.45%~100%,肿瘤消失率为70.60%(257/364);T1a期肿瘤消失率显著高于T1b期PTC(P<0.05)。结论MWA治疗孤立性T1N0M0期PTC的安全性及有效性与SR相当。Objective To comparatively observe the value of microwave ablation(MWA)and surgical resection(SR)for treating solitary T1N0M0 papillary thyroid carcinoma(PTC).Methods Data of 728 patients with isolated T1N0M0 PTC who underwent MWA(MWA group,n=364)or SR(SR group,n=364)were retrospectively analyzed.The surgical data and postoperative follow-up data were compared between groups,and the therapeutic effects of MWA and SR were analyzed.Results The operation time of MWA group and SR group was 23(14,38)min and 72(33,180)min,the intraoperative blood loss was 2(1,5)ml and 10(8,30)ml,and the postoperative hospital stay was 1(1,3)days and 2(1,6)days,respectively,all were significantly different(all P<0.01).Disease progression was noticed in 16 cases(1 of local recurrence,12 of new PTC and 3 of cervical lymph node metastasis)of MWA group and 15 cases(11 of new PTC and 4 of cervical lymph node metastasis)of SR group,and no significant difference was found between groups(all P>0.05).The incidence of complications were not significantly different between groups(χ^(2)=-3.36,P>0.99).At the end of follow-up,in MWA group,tumor shrinkage rate of T1 stage PTC was 89.45%—100%,tumor disappearance rate was 70.60%(257/364),and the tumor disappearance rate of T1a stage PTC was significantly higher than that of T1b stage(P<0.05).Conclusion The safety and effectiveness of MWA were all better than those of SR for treating solitary T1N0M0 PTC.

关 键 词：甲状腺癌 乳头状 超声检查 消融技术 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]