【摘要】 目的 通过孤立性cN0期甲状腺微小乳头状癌(PTMC)微波消融(MWA)与手术切除的对比，进一步探讨微波消融治疗孤立性cN0期PTMC的临床疗效。方法 回顾性分析孤立性cN0期PTMC患者130例(消融组74例和外科组56例),评估消融组病灶缩小率及消失率，对比两组手术成功率、并发症、复发、淋巴结转移及患者SF-36生活质量评分表。结果 两组手术成功率为100%。消融组术后第1、第3、第6、第12、第24个月比较病灶缩小率差异有统计学意义(P<0.01),分别为(-428.36±576.29)%、(-120.71±208.10)%、(22.86±111.52)%、(85.90±29.33)%、(99.34±5.64)%;第24个月病灶消失率达98.64%(73/74)。两组复发及淋巴结转移率为0。两组并发症发生率差异有统计学意义(P<0.01),消融组并发症发生率为17.56%(13/74),而外科组高达82.14%(46/56)。两组手术前后生理健康(PCS)得分差异无统计学意义(P>0.05);术后第3、第6、第12、第24个月心理健康(MCS)得分和SF-36总分差异有统计学意义(P<0.05),消融组得分明显优于外科组。结论 微波消融对可能存在隐匿性淋巴结转移的cN0期PTMC患者短期内有良好疗效。更多还原

【Abstract】 Objective To further explore the clinical efficacy of microwave ablation for isolated stage cN0 papillary thyroid microcarcinoma(PTMC) by comparing with surgical resection. Methods A retrospective analysis was performed on 130 patients with isolated cN0 stage PTMC(74 patients in ablation group and 56 patients in surgical group). The reduction rate and disappearance rate of lesions in ablation group were evaluated, and the success rate of surgery, complications, recurrence, lymph node metastasis and SF-36 quality of life of patients in the two groups were compared. Results The success rate of the two groups was 100%. There was significant difference in lesion reduction rate in the ablation group at 1st, 3rd, 6th, 12nd and 24th months after surgery(P<0.01). They were(-428.36±576.29)%,(-120.71±208.10)%,(22.86±111.52)%,(85.90±29.33)%,(99.34±5.64)%, respectively; At the 24th month, the lesion disappearance rate was 98.64%(73/74). The rate of recurrence and lymph node metastasis in the two groups was 0. There was a statistically significant difference in the incidence of complications between the two groups(P<0.01), which was 17.56%(13/74) in the ablation group and 82.14%(46/56) in the surgical group. There was no significant difference in physical component summary(PCS) scores between the two groups before and after surgery(P>0.05). At 3rd, 6th, 12nd and 24th months after surgery, mental component summary(MCS) scores and SF-36 scores were significantly different(P<0.05), and the scores of the ablation group were significantly better than those of the surgical group. Conclusions Microwave ablation has a good short-term effect on cN0 stage PTMC patients with latent lymph node metastasis.更多还原