背景:近年来,甲状腺结节的发病率明显增加。治疗甲状腺结节的方法多种多样,而消融治疗是治疗甲状腺结节的重要方法之一。然而,目前甲状腺结节消融治疗存在许多并发症和不足,尤其是甲状腺癌结节的不完全消融,这限制了消融技术的进一步应用。在本文中,我们报告了2例甲状腺结节不完全消融术,其中一人由于消融后的焦虑而接受了手术治疗,术后病理证实仍有甲状腺乳头状癌残留,另一名患者在消融后接受了手术,但是由于颈部淋巴结转移在短时间内再次访问了我们的医疗机构,在根治性颈淋巴结清扫术后,病理证实为多发颈淋巴结转移。手术后进行放射性核素治疗,两名患者目前正在接受内分泌抑制治疗,病情稳定无复发迹象.
结论:甲状腺癌结节的不完全消融限制了消融治疗的发展,使消融治疗成为一把双刃剑。准则和专家共识可以指导其发展,但是它们需要与时俱进,多学科诊断团队可以帮助筛选最合适的患者。只有更规范地使用这项技术,使用最合适的技术,治疗最合适的病人,可以使越来越多的患者受益。
BACKGROUND: In recent years, the incidence of thyroid nodules has increased significantly. There are various ways to treat thyroid nodules, and ablation therapy is one of the important ways to treat thyroid nodules. However, there are many complications and deficiencies in the current ablation treatment of thyroid nodules, especially the incomplete ablation of thyroid cancer nodules, which limits the further application of ablation technology. In this paper, we report two cases of incomplete ablation of thyroid nodules, one of which underwent surgical treatment due to anxiety after ablation, and the postoperative pathology confirmed that there was still residual papillary thyroid carcinoma, and the other patient underwent an operation after ablation, but visited our medical institution again due to cervical lymph node metastasis in a short period of time, and after radical cervical lymph node dissection, pathology confirmed multiple cervical lymph node metastasis. Radionuclide therapy was performed after surgery, and two patients are currently receiving endocrine suppression therapy, and their condition is stable with no signs of recurrence.
CONCLUSIONS: The incomplete ablation of thyroid cancer nodules limits the development of ablation therapy, making ablation treatment a double-edged sword. Guidelines and expert consensus can guide their development, but they need to evolve with the times, and a multidisciplinary diagnostic team can help screen the most suitable patients. Only by using this technology more standardly, using the most appropriate technology, and treating the most suitable patients, can benefit more and more patients.