超声引导下射频消融治疗甲状腺微小乳头状癌术后吸收率相关免疫因素分析  

Analysis of Immunological Factors Related to the Absorption Rate of Papillary Thyroid Microcarcinoma After Ultrasound-Guided Radiofrequency Ablation

作　　者：贾筱夏 常莹[1] 侯文颖 符颖[1] 张会单 杨敬春[1] Jia Xiaoxia;Chang Ying;Hou Wenying;Fu Ying;Zhang Huidan;Yang Jingchun(Department of Diagnostic Ultrasound,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院超声诊断科,北京市100053

出　　处：《中国超声医学杂志》2024年第6期609-612,共4页Chinese Journal of Ultrasound in Medicine

基　　金：首都医科大学临床专科学院(系)培养基金开放课题(No.CCMU2023ZKYXY022);北京市科学技术协会青年人才托举工程项目(No.BYESS2024017)。

摘　　要：目的 探讨与超声引导下射频消融(RFA)治疗甲状腺微小乳头状癌(PTMC)患者术后结节吸收率相关的外周血免疫细胞水平和外周血炎性标志物。方法 本研究对2020年12月至2022年3月进行超声引导下RFA治疗的PTMC患者进行了回顾性分析。以术后结节体积减小百分率(VRR)达到100%的时间作为吸收率评估指标,采用单因素卡方检验及二元Logistic回归分析RFA术后结节吸收率的影响因素。结果 本研究通过对RFA术后吸收率和外周血免疫细胞水平的分析发现,外周血中性粒细胞数量、中性粒细胞/淋巴细胞比值(NLR)、系统性免疫性炎症指数(SII)减低和淋巴细胞/单核细胞比值(LMR)升高与患者RFA术后吸收不良(达到100%VRR时间>12个月)相关。二元Logistic回归分析显示外周血中性粒细胞数是RFA术后PTMC吸收率的独立影响因素。结论 影响超声引导下RFA治疗PTMC术后吸收率的免疫因素包括外周血中性粒细胞数目、NLR、SII和LMR。外周血免疫细胞水平评估RFA术后吸收率具有简便、经济、可重复的特点,可为PTMC的RFA术前评估和综合诊疗提供更多参考。Objective To explore the peripheral blood immune cell levels and peripheral blood inflammatory markers related to the absorption rate of ultrasound-guided radiofrequency ablation(RFA)in the treatment of papilla-ry thyroid microcarcinoma(PTMC).Methods This study performed a retrospective analysis of patients with ultra-sound(US)guided RFA for PTMC between December 2020 and March 2022.Taking the time when postoperative nodules reach 1oo%volume reduction ratio(VRR)as the absorption rate evaluation index,univariate chi-square test and Logistic regression were used to analyze the influencing factors of RFA treatment.Results Through the analysis of peripheral blood immune cell levels possibly affecting absorption rate after RFA,we found that decrease in the num-ber of neutrophils in peripheral blood was associated with low absorption rate(100%VRR time greater than 12 months).Analysis of peripheral blood inflammatory markers showed that decreased neutrophil to lymphocyte ratio(NLR),systemic immune-inflammation index(SI),and increased lymphocyte to monocyte ratio(LMR)were related to low absorption rate in patients.Logistic regression analysis showed that number of neutrophils in peripheral blood was independent influencing factor affecting the rate of absorption after RFA in PTMC patients.Conclusions Immu-nological features affecting the absorption rate of thyroid nodules by US-guided RFA include number of neutrophils in peripheral blood,NLR,SII and LMR.The peripheral blood immune cell level is simple,economical and reproducible parameter to evaluate the postoperative absorption rate after RFA,which can provide more references for the preoper-ative evaluation and comprehensive diagnosis and treatment of RFA in PTMC.

关 键 词：超声引导下射频消融 甲状腺微小乳头状癌 中性粒细胞/淋巴细胞比值 淋巴细胞/单核细胞比值 系统性免疫性炎症指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]