微波消融与外科手术治疗多灶性cN0期甲状腺微小癌的临床对比研究  

Microwave Ablation Versus Operation Treatment for Multifocal cN0 Papillary Thyroid Microcarcinoma:A Clinical Comparative Study

作　　者：张锡瑜 何俊峰[2] 闫国珍[2] 刘扬[2] 熊睿[2] 石包圣 Zhang Xiyu;He Junfeng;Yan Guozhen;Liu Yang;Xiong Rui;Shi Baosheng(Postgraduate School of Baotou Medical College,Baotou,Inner Mongolia 014040,China;Department of Ultrasound Medicine,The First Affiliated Hospital of Baotou Medical College,Baotou,Inner Mongolia 014040,China)

机构地区：[1]包头医学院研究生院,内蒙古包头市014040 [2]包头医学院第一附属医院超声医学科,内蒙古包头市014040

出　　处：《中国超声医学杂志》2024年第5期489-492,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的对比微波消融(MWA)与外科手术(Op)治疗多灶性cN0期甲状腺微小乳头状癌(cN0-PTMC)的临床疗效,以期为多灶性cN0-PTMC的最佳治疗方式选择提供更多证据。方法收集多灶性cN0-PTMC患者共111例,根据治疗方式分为MWA组(57例,共124个病灶)及Op组(54例,共130个病灶)。术后随访3年,比较两组患者的一般资料、住院时间、并发症、复发转移率及患者满意度,并观察MWA组治疗前后病灶平均体积、缩小率和消失率变化情况。结果MWA及Op治疗多灶性cN0-PTMC有效性均为100%,术后两组均无复发及影像学淋巴结转移。MWA组术后1、3、6、12、24、36个月病灶体积缩小率差异均有统计学意义(P<0.05),病灶消失率分别为0、1.61%、22.58%、72.58%、95.16%、98.38%。两组住院时间、并发症发生率差异均有统计学意义(P<0.05)。治疗后MWA组患者的活力、社会功能、情感职能、精神健康得分和总分均高于Op组,差异有统计学意义(P<0.05)。结论MWA为可能有隐匿性淋巴结转移的多灶性cN0-PTMC患者提供了新的治疗选择。Objective To compare the clinical efficacy of microwave ablation(MWA)and operation(Op)treatment for multifocal cN0 papillary thyroid microcarcinoma(PTMC)and provide additional evidence for the optimal treatment approach for multifocal cN0-PTMC.Methods A total of 111 patients with multifocal cN0-PTMC were included and assigned to the MWA group(57 cases with 124 lesions in total)and the Op group(54 cases with 130 lesions in total)depending on the choice of treatment.3 years of postoperative follow-up included comparisons of general patient information,length of hospital stay,complications,the recurrence/metastasis rate,and patient satisfaction.Furthermore,changes in the average volume,volume reduction rate,and disappearance rate of lesions before and after MWA were observed and documented.Results Both the MWA and Op groups exhibited an overall response rate of 100%,with no recurrence or radiographic lymph node metastasis in either group after treatment.The volume reduction rate of lesions in the MWA group at 1,3,6,12,24,and 36 months post-treatment showed statistically significant differences(P<0.05),with lesion disappearance rates of 0,1.61%,22.58%,72.58%,95.16%,and 98.38%,respectively.There were statistically significant differences in the length of hospital stay and complications between the two groups(P<0.05,respectively).After treatment,the MWA group scored significantly higher for vitality,social functioning,role-emotional,and mental health,indicating the achievement of significantly higher total scores compared to the Op group(P<0.05,respectively).Conclusions MWA offers a new option for patients with multifocal cN0-PTMC who may have occult lymph node metastasis.

关 键 词：多灶性 甲状腺微小乳头状癌 微波消融 外科手术 

分 类 号：R73[医药卫生—肿瘤]