Abstract

Purpose: To evaluate the efficacy and safety of microwave ablation (MWA) for cervical metastatic lymph nodes (LNs) post resection of papillary thyroid cancer (PTC).

Materials and methods: From November 2015 to November 2018, 14 patients with 38 cervical metastatic LNs treated by MWA were included in this retrospective study. Wilcoxon signed rank test was used to compare the changes of LN and serum thyroglobulin levels pre- and post-ablation.

Results: The technical success rate in this study was 100% (38/38). The mean follow-up time was 23.6 ± 9.3 months. On pre-ablation contrast-enhanced ultrasound, 25 LNs showed high-enhancement, 8 LNs showed iso-enhancement, and 5 LNs showed low-enhancement. The median largest diameter of LNs at pre-ablation and 3, 6, 9, 12, 18, 24, and 36 months post-ablation was 11.5 mm and 9.5, 9.0, 8.0, 8.0, 8.0, 7.0, and 6.0 mm, respectively. The median volume of LNs at pre-ablation and 3, 6, 9, 12, 18, 24, and 36 months post-ablation were 251.2 mm³ and 206.7, 167.2, 166.2, 155.7, 153.9, 153.9, and 113.1 mm³, respectively. The largest diameter and the volume of the cervical metastatic LNs at the last post-ablation was significantly smaller than the pre-ablation level (p = .0016; p = .0018). Serum Tg level at the last post-ablation (median 1.25 ng/mL) was significantly lower than the pre-ablation level (median 8.35 ng/mL) (p = .001). There were no complications.

Conclusion: MWA is a safe and effective novel treatment option for cervical metastatic LN that emerge post resection of PTC.

摘要

目的：评估微波消融术（MWA）对甲状腺乳头状癌（PTC）切除后宫颈转移性淋巴结（LN）的有效性和安全性。

资料和方法：回顾性研究从2015年11月至2018年11月，通过MWA治疗的14例38例宫颈转移性LN患者。用Wilcoxon符号秩和检验比较消融前后LN和血清甲状腺球蛋白水平的变化。

结果：本研究的技术成功率为100％（38/38）。平均随访时间为23.6±9.3个月。在消融前对比增强超声检查中，有25个LN呈高增强状态，有8个LN呈同度增强状态，有5个LN呈低增强状态。消融前和消融后3、6、9、12、18、24和36个月LN的最大中值直径分别为11.5 mm和9.5、9.0、8.0、8.0、8.0、7.0和6.0 mm 。消融前和消融后3、6、9、12、18、24和36个月LN的中位数为251.2 mm ³和206.7、167.2、166.2、155.7、153.9、153.9和113.1 mm ³，分别。最后一次消融后宫颈转移性LN的最大直径和体积显着小于消融前水平（p = .0016; p  = .0018）。最后一次消融后的血清Tg水平（中位数1.25 ng / mL）显着低于消融前的水平（中位数8.35 ng / mL）（p  = .001）。没有并发症。

结论： MWA是治疗PTC术后宫颈转移性LN的一种安全有效的新型治疗选择。