摘要
背景超声引导下射频消融(radiofrequency ablation,RFA)对甲状腺癌术后患者侧颈区与中央区的转移性淋巴结(cervical lymph nodes metastasis,CLNM)疗效的对比研究较少。目的评估RFA对甲状腺癌全切术后侧颈区和中央区CLNM的治疗效果和并发症发生情况。方法回顾性分析2020年1月—2021年1月在解放军总医院第一医学中心超声诊断科行RFA治疗甲状腺癌全切术后发生侧颈区和中央区CLNM的患者,随访截至2023年1月1日,对比两组患者消融前后的CLNM体积和消融后体积缩小率(volume reduction rate,VRR)以及消融时和随访中的并发症发生情况。结果共52例患者(96枚CLNM)纳入研究。侧颈区38例(74枚CLNM),男性10例,女性28例,平均年龄(43.1±8.3)岁;中央区14例(22枚CLNM),男性4例,女性10例,平均年龄(34.4±16.3)岁。两组年龄和性别无统计学差异(P>0.05)。侧颈区和中央区的CLNM在消融后1个月、3个月、6个月、12个月和24个月体积逐渐减小且VRR逐渐增加,随访2年内CLNM完全消失,且各随访节点两组间的CLNM体积和VRR差异均无统计学意义(P>0.05)。消融时6例有颈部疼痛(侧颈区2例,中央区4例),无其他轻微不良反应和严重并发症发生。随访期间8例(15.4%)出现消融区域外的复发(侧颈区3例,中央区5例),均成功完成二次RFA。结论RFA对甲状腺癌全切术后颈部侧颈区和中央区的CLNM均有良好的有效性和安全性。
Background Comparative studies on the effectiveness of ultrasound-guided radiofrequency ablation(RFA)of cervical lymph nodes metastatic(CLNM)in the lateral and central regions of patients after thyroid cancer surgery are rare.Objective To evaluate the efficacy and complications of RFA in treating CLNM in the lateral and central cervical region after total thyroidectomy.Methods A retrospective analysis was performed on patients with CLNM in the lateral and central cervical region after total thyroidectomy treated with RFA in the Ultrasound Diagnostic Department of the First Medical Center of Chinese PLA General Hospital from January 1,2020 to January 1,2021.The volume of CLNM before and after ablation,the volume reduction rate(VRR)after ablation,and the incidence of complications during ablation and follow-up were compared between the two groups.Results A total of 52 patients with average age of(40.73±11.35)years old(14 males)with 96 CLNM were included in the study,including 38 patients(74 CLNM)in the lateral and 14 patients(22 CLNM)in the central.At 1,3,6,12,and 24 months after ablation,the volume of CLNM in the lateral and the central gradually decreased and VRR gradually increased.CLNM disappeared completely within 2 years of follow-up,and there were no statistical differences in the volume and VRR of CLNM at each follow-up time points between the two groups.There were only 6 patients with minor adverse reactions(neck pain)during ablation,2 in the lateral group and 4 in the central group.No other minor adverse reactions or major complications occurred.During follow-up,8 patients(15.4%)developed new recurrent lesions outside the ablation area(3 in the lateral area,5 in the central area),and all of them successfully completed the second RFA.Conclusion RFA has shown efficacy and safety for CLNM in the lateral and central cervical regions after total thyroidectomy.
作者
孟书玉
阎琳
张艳
罗渝昆
MENG Shuyu;YAN Lin;ZHANG Yan;LUO Yukun(Chinese PLA Medical School,Beijing 100853,China;Department of Ultrasound,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
2024年第4期344-348,共5页
Academic Journal of Chinese PLA Medical School
基金
国家自然科学基金项目(81901746)。
关键词
超声引导下射频消融
甲状腺癌术后
颈部转移性淋巴结
超声检查
并发症
ultrasound-guided radiofrequency ablation
post-operation of thyroid carcinoma
cervical lymph nodes metastasis
ultrasonography
complication
作者简介
孟书玉,女,在读硕士。研究方向:超声医学。Email:msydoctor@163.com;通信作者:罗渝昆,女,博士,主任医师,教授,博士生导师。Email:lyk301@163.com。
