经皮微波消融治疗甲状腺微小乳头状癌临床疗效评价  

Clinical efficacy evaluation of percutaneous microwave ablation for papillary thyroid microcarcinoma

作　　者：苏昊博 黄倩 张涛 王文平[1] SU Haobo;HUANG Qian;ZHANG Tao;WANG Wenping(Department of Ultrasound,Nanjing Jiangning Hospital,Nanjing 211100,China;Department of Ultrasound,Jiangsu Cancer Hospital,Nanjing 210009,China;Department of Ultrasound,Nanjing Jiangning Hospital of Traditional Chinese Medicine,Nanjing 211100,China)

机构地区：[1]南京市江宁医院超声诊断科,江苏南京211100 [2]江苏省肿瘤医院超声诊断科,江苏南京210009 [3]南京市江宁中医院超声诊断科,江苏南京211100

出　　处：《中国肿瘤外科杂志》2024年第4期330-334,共5页Chinese Journal of Surgical Oncology

基　　金：江苏大学医学教育协同创新基金(JDYY2023012);南京医科大学康达学院科研发展基金课题重点项目(KD2020KYJJZD008)。

摘　　要：目的探讨和评价经皮微波消融治疗甲状腺微小乳头状癌(PTMC)的临床疗效。方法选取2016年4月至2018年5月江苏省肿瘤医院、南京市江宁医院、南京江宁中医院甲状腺治疗中心PTMC患者108例,共118个病灶,超声实时监测及引导下微波局部区域完全消融;主要评价指标包括超声影像、实验室检查:甲状腺功能及外周血免疫学指标(CD4、CD8、CD4/CD8),同时观察临床症状及体征,并对上述指标随访和评价。结果PTMC微波消融术全部病例术后多次定期随访甲状腺功能均正常,无并发症发生(此结果属于干预措施的安全性评价内容);消融术前、后外周血T淋巴细胞亚群检测CD4,CD4/CD8水平呈升高趋势;CD8水平呈下降趋势,时间点间免疫结果差异均有统计学意义(P<0.05);术后体积随访消融结节呈持续性缩小,6、12、18个月体积缩小比较差异有统计学意义(P<0.05);且18个月时有37.29%(44/118,)的结节完全消失(P<0.05)。结论临床疗效评价表明经皮微波消融治疗PTMC是值得临床推广应用的新技术。Objective To investigate and evaluate the clinical efficacy of percutaneous microwave ablation in the treatment of papillary thyroid microcarcinoma(PTMC).Methods One hundred and eight patients with PTMC in the thyroid treatment centers of Jiangsu Cancer Hospital,Nanjing Jiangning Hospital and Nanjing Jiangning Hospital of Traditional Chinese Medicine from April 2016 to May 2018 were selected,with a total of 118 lesions.Real⁃time ultrasound monitoring and guided microwave complete ablation of local areas were performed;Clinical observation indexes included clinical symptoms and signs,ultrasound imaging,laboratory tests:Thyroid function and peripheral blood immunological indexes(CD4,CD8,CD4/CD8),and the above indexes were followed up and evaluated.Results In all cases of PTMC microwave ablation,thyroid function was normal and no complications occurred after multiple regular follow⁃up after PTMC microwave ablation(This result belongs to the safety evaluation of the intervention);CD4 and CD4/CD8 levels in peripheral blood before and after the ablation showed an increasing trend;CD8 levels showed a decreasing trend,and the difference in immunological results between time points was statistically significant(P<0.05);The volume of ablated nodules showed a continuous reduction after the operation and the difference in volume reduction at the 6th,12th and 18th months was statistically significant(P<0.05);And 44 nodules had completely disappeared at the 18th months(44/118,37.29%).Conclusions The clinical efficacy evaluation shows that percutaneous microwave ablation in the treatment of papillary thyroid microcarcinoma is a new technology that is worthy of clinical application.

关 键 词：经皮微波消融治疗 甲状腺微小乳头状癌 临床系统疗效评价 

分 类 号：R736.1[医药卫生—肿瘤]