Thyroid:甲状腺良性结节射频和激光消融的五年结局

2020-06-27 MedSci原创 MedSci原创

两种热消融技术均能使良性甲状腺结节患者获得临床上显著且持久的体积减少。RFA后,再生和需要再次治疗的风险较低。再次治疗与年龄小、基线体积大和能量输送低的治疗有关。

射频和激光消融(RFA和LA)是治疗甲状腺良性结节的有效方法。由于其是相对较新的临床治疗手段,因此长期随访研究有限。近日,甲状腺疾病领域权威杂志Thyroid上发表了一篇研究文章,这项研究旨在评估RFA或LA后5年内的疗效、再生率和再治疗率,并确定结局的预测因素。

在这项多中心回顾性研究中,研究人员评估了406例接受RFA或LA治疗并在初始治疗后随访5年的患者的疗效、再生长和再治疗情况。倾向得分匹配用于比较治疗效果,采用风险模型的累积发生率研究来描述再生和再治疗趋势并确定预后因素。研究人员使用Logistic回归模型和受试者操作特征分析来确定危险因素及其临界值。

RFA和LA可显著减少甲状腺良性结节的体积,并且这种减少通常可维持5年。74%的患者(RFA为85%,LA组为63%)获得了治疗功效(定义为治疗1年后降低≥50%)。在28%的患者中发生了再生长(RFA为20%,LA组为38%)。大多数病例不需要进一步治疗,因为仅18%的患者需要再次治疗(RFA为12%,LA组为24%)。这些数据通过倾向得分匹配得到证实。累积发生率研究表明,RFA与较低的再生风险和需要再次治疗的风险较低相关。总体而言,治疗无效和再生长与能量输送低有关。在年轻、大结节、1年时体积减少较少以及低能量输送(RFA的最佳截止值为918 J/mL)的患者中,再次治疗更为频繁。

由此可见,两种热消融技术均能使良性甲状腺结节患者获得临床上显著且持久的体积减少。RFA后,再生和需要再次治疗的风险较低。再次治疗与年龄小、基线体积大和能量输送低的治疗有关。

原始出处:

Stella Bernardi,et al.Five-year results of radiofrequency and laser ablation of benign thyroid nodules: a multicenter study from the Italian minimally-invasive treatments of the thyroid group.Thyroid.2020.https://www.liebertpub.com/doi/10.1089/thy.2020.0202

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    2021-09-14 xieqian_78

    !!!!!

    0

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    2020-06-27 mswert122

    #甲状腺结节#问题在于甲状腺结节需要消融吗?

    1

    展开1条回复
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    2020-06-29 oliver169
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