超声引导下微波消融术治疗甲状腺肿瘤对术后肿瘤区细胞存活与远期复发的影响

Effect of Ultrasound-guided Microwave Ablation on Cell Survivaland Long-term Recurrence of Thyroid Tumors

目的:研究超声引导下微波消融术在甲状腺肿瘤治疗中对术后肿瘤区细胞存活和远期复发的影响。方法:选择宜宾市第一人民医院2018年3月至2021年9月间收治的70例甲状腺肿瘤患者作为研究对象,根据术前穿刺活检结果将其分为良性组(40例)和恶性组(30例),对两组患者均进行超声引导下微波消融术,评估两组患者的临床治疗效果(包括肿瘤区细胞存活率、消融区域体积变化、术后反应发生率以及远期复发率等)。结果:术后即刻、术后半年良性组与恶性组的峰值强度(Peak)、达峰时间(TTP)、平均通过时间(MTT)无明显差异(P>0.05),而术后一年及以上时,恶性组的Peak显著降低,TTP和MTT显著延长(P<0.05);良性组体积由0.68 mL缩小到0.17 mL,体积缩窄率75%,恶性组体积由0.65 mL缩小到0.27 mL,体积缩窄率58%,良性组的缩小趋势更为明显,两组的术后反应发生率对比无明显差异(P>0.05);但恶性组术后采取其他治疗措施数量高于良性组(P<0.05);经过一年随访后,两组之间的复发率差异无统计学意义(P>0.05)。结论:在甲状腺肿瘤良性患者中,超声引导下微波消融术在其中具有良好的治疗作用,可以改善消融区域的组织修复和血供情况,同时术后反应较少,对于存在淋巴转移或远处转移者的甲状腺恶性肿瘤患者,在消融区体积、远期复发方面具有一定局限性。

Objective:To investigate the effect of ultrasound-guided microwave ablation on cell survival and long-term recurrence in the treatment of thyroid tumors.Methods:A total of 70 patients with thyroid tumors admitted to the First People’s Hospital of Yibin from March 2018 to September 2021 were selected as the research objects,and they were divided into 40 benign group and 30 malignant groups according to the results of preoperative needle biopsy.Results:Peak intensity,time to peak(TTP)between benign and malignant groups immediately postoperatively and six months after surgery.There was no significant difference in mean transit time(MTT)(P>0.05),but at one year or more,the peak of the malignant group was significantly reduced,and the TTP and MTT were significantly extended(P<0.05).The ablation area volume in the benign group reduced from 0.68 mL to 0.17 mL (75% reduction), while in the malignant group, it reduced from 0.65 mL to 0.27 mL (58% reduction), with a more obvious reduction trend in the benign group. There was no significant difference in postoperative response rates between the two groups ( P >0.05 ), but the number of additional treatments taken by the malignant group was higher than that of the benign group ( P <0.05). After one year of follow-up, there was no statistically significant difference in recurrence rate between the two groups ( P >0.05). Conclusion: Ultrasound-guided microwave ablation has a good therapeutic effect in patients with benign thyroid tumors, which can improve tissue repair and blood supply in the ablation area, and has fewer postoperative reactions.