甲状腺微小癌的热消融治疗

Thermal ablation of thyroid microcarcinoma

甲状腺微小癌包括各种亚型的甲状腺癌,但主要指甲状腺微小乳头状癌(PTMC),其发病率增长迅速但复发率和死亡率均无明显增加。热消融作为近年来发展迅速的新技术,包括激光消融、射频消融及微波消融。国内已有多个研究者尝试将其用于PTMC的一线治疗,具有一定的有效性和安全性。虽然目前已有一些指南和共识提出了热消融的指征,但最佳的适应证、术前评估肿瘤和淋巴结情况、合理的术后管理等,仍是热消融用于PTMC一线治疗需要面临的巨大挑战。

Thyroid microcarcinoma,including various subtypes of thyroid cancer,mainly refers to thyroid papillary microcarcinoma(PTMC).The incidence of PTMC has raised rapidly,but the recurrence and the mortality had no significant increase.As a new technique developed rapidly in recent years,thermal ablation,including laser ablation,radiofrequency ablation and microwave ablation,has been attempted as the first-line treatment of PTMC due to its good efficacy and safety.Although some indications of thermal ablation have suggested by a few of guidelines and consensus,appropriate indications,preoperative evaluation of tumor and lymph glands and suitable postoperative management have still been challenging for thermal ablation used in the first-line treatment of PTMC.