目的:回顾性分析激光消融(LA)与微波消融(MWA)治疗甲状腺乳头状微小癌(PTMC)的疗效及安全性。
方法:这是一项回顾性研究,对2019年10月至2023年3月期间接受PTMC热消融的103例患者(109个结节)进行了回顾性研究;61例接受LA治疗,48例接受MWA治疗。患者平均年龄为43.50±12.42岁。消融后,肿瘤大小在不同时间点的变化,局部复发,新的病变,淋巴结转移,并对并发症进行评估和记录。可行性,成功率,并对LA和MWA的安全性进行了分析。
结果:消融后,所有靶肿瘤的超声造影完全没有增强。在最后一次随访中,PTMC结节的平均体积从0.09±0.09下降到0.03±0.03ml(LA组),从0.11±0.10下降到0.06±0.08ml(MWA组)(两者,P<0.05)。两组之间的体积变化没有显着差异(P(组):0.520;P(随时间的变化):0.423),表明两组之间的疗效相似。在随访期间,两组之间的体积减少率也没有显着差异。3个月时除外(P=0.023)。LA组(8.2%)和MWA组(6.3%)之间的并发症发生率没有差异(P>0.05)。
结论:在短期随访期间,超声引导LA和MWA对PTMC是有效和安全的,两种方法之间的治疗结局无显著差异.
OBJECTIVE: To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC).
METHODS: This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients\' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed.
RESULTS: Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, P < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (P = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (P > 0.05).
CONCLUSIONS: During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.