中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2021, Vol. 43 ›› Issue (4): 584-589.doi: 10.3881/j.issn.1000-503X.13277

• 论著 • 上一篇    下一篇

粗针穿刺活检在射频消融治疗甲状腺微小乳头状癌中的临床应用

阎琳1,2,宋青1,肖静1,张颖1,罗渝昆1()   

  1. 1中国人民解放军总医院第一医学中心超声诊断科,北京 100853
    2大连医科大学附属第二医院健康管理中心,辽宁大连 116023
  • 收稿日期:2020-08-17 出版日期:2021-08-30 发布日期:2021-09-03
  • 通讯作者: 罗渝昆 E-mail:lyk301@163.com
  • 基金资助:
    国家自然科学基金(81771834)

Value of Ultrasound-guided Core-needle Biopsy for Evaluating the Performance of Radiofrequency Ablation for Low-risk Papillary Thyroid Microcarcinoma

YAN Lin1,2,SONG Qing1,XIAO Jing1,ZHANG Ying1,LUO Yukun1()   

  1. 1Department of Ultrasound,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China
    2Health Management Center,The Second Hospital of Dalian Medical University,Dalian,Liaoning 116023,China
  • Received:2020-08-17 Published:2021-08-30 Online:2021-09-03
  • Contact: LUO Yukun E-mail:lyk301@163.com
  • Supported by:
    National Natural Science Foundation of China(81771834)

摘要:

目的 探讨粗针穿刺评价射频消融治疗甲状腺微小乳头状癌疗效的应用价值。方法 回顾性分析2016年6月至2018年9月行射频消融(RFA)治疗单发低危甲状腺微小乳头状癌患者190例,随访时间均大于12个月,其中女性142例、男性48例,年龄20~74岁,肿瘤平均体积(106.29±96.15)mm3。RFA术后1、3、6、12个月及随后每半年行超声和超声造影检查评估消融灶体积、颈部淋巴结及甲状腺实质情况。于术后第3或6个月对消融灶中心部、周边部及周围正常甲状腺实质分别行粗针穿刺(CNB)评价消融疗效。结果 患者的平均随访时间为(30.04±12.41)个月,体积由(106.29±96.15)mm3缩小至(1.47±8.00)mm3,体积缩小率为(99.08±4.32)%。术后两枚消融灶病理阳性,均出现在消融灶周边部,随即进行补充消融。随访过程中,无患者出现复发转移。所有患者的手术及CNB均顺利进行,无并发症发生。结论 CNB是一种便捷有效的评价低危甲状腺微小乳头状癌消融有效性的检查方法,可在消融术后早期发现残留肿瘤。

关键词: 超声, 射频消融, 甲状腺微小乳头状癌, 粗针穿刺

Abstract:

Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm3]treated by RFA from June 2016 to September 2018 were evaluated in this study.During the RFA procedure,enlarged ablation was performed.Patients were followed up 1,3,6,12 months after RFA and every 6 months thereafter.The volume of ablation area and the volume reduction ratio(VRR)were calculated.To evaluate the ablation performance,CNB was performed to the central zone,the peripheral zone,and surrounding thyroid parenchyma 3 or 6 months after RFA. Results The mean follow-up time was(30.04±12.41)months.The mean volume of tumor significantly decreased from(106.29±96.15)mm3 to(1.47±8.00)mm3.Two ablated tumors were diagnosed to have residue by CNB and underwent additional RFA.No recurrence,metastatic lymph nodes,or distal metastasis were found during the follow-up.All the patients were tolerable to RFA and CNB procedure. Conclusion CNB can be used to evaluate the ablation performance after RFA for low-risk PTMC.

Key words: ultrasound, radiofrequency ablation, papillary thyroid microcarcinoma, core-needle biopsy

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