Abstract

Background

Whether thyroid function would be affected by ablation remains controversial. This systematic review and meta-analysis aimed to investigate the effects of energy-based ablation on thyroid function in treating benign thyroid nodules.

Methods

EMBASE, PubMed, Cochrane Library, and Web of Science databases were searched. The mean difference (MD) or standard MD (SMD) was applied to assess changes in thyroid function, thyroglobulin (Tg), and antibodies after ablation. RevMan version 5.3 was used for data synthesis.

Results

Forty-two studies involving 6380 patients were eligible. The pooled results revealed significant decrease of 1-day thyroid-stimulating hormone (95% CI, −0.67 to −0.14), significant increase of 1-day, 1-week, and 1-month free thyroxine (95% CI, 1.57 to 5.28; 95% CI, 0.61 to 2.42; 95% CI, −0.76 to −0.15), 1-day and 1-week Tg level (95% CI, 0.40 to 0.81; 95% CI, 0.21 to 1.29), 6-month anti-thyroglobulin antibodies (95% CI, 0.02 to 0.26), 1- and 3-month thyroperoxidase antibody (95% CI, 0.02 to 0.22; 95% CI, 0.17 to 0.43), and 1-day, 1-, and 3-month thyrotrophin receptor antibody (95% CI, 0.10 to 0.43; 95% CI, 0.00 to 0.30; 95% CI, 0.13 to 0.36) after ablation. No statistically significant differences were found in these six indicators in the longer term. The results of subgroup analysis were similar to the pooled results. No significant publication bias was found.

Conclusions

Energy-based ablation was more likely to have negative effects on thyroid function and antibodies and led to transient increase in Tg level in the short term. However, most of the patients would not develop any thyroid dysfunction in the long-term follow-up.

中文翻译：

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基于能量的消融对甲状腺良性结节的甲状腺功能的影响：系统评价和荟萃分析。

摘要

背景

甲状腺功能是否会受到消融影响仍存在争议。这项系统的综述和荟萃分析旨在研究能量消融对甲状腺良性结节的甲状腺功能的影响。

方法

搜索了EMBASE，PubMed，Cochrane图书馆和Web of Science数据库。应用平均差异（MD）或标准MD（SMD）评估消融后甲状腺功能，甲状腺球蛋白（Tg）和抗体的变化。RevMan 5.3版用于数据综合。

结果

涉及6380名患者的42项研究符合条件。汇总结果显示，第1天甲状腺刺激激素显着下降（95％CI，-0.67至-0.14），第1天，1周和1个月游离甲状腺素显着增加（95％CI，1.57至1.57）。 5.28; 95％CI，0.61至2.42; 95％CI，-0.76至-0.15），1天和1周Tg水平（95％CI，0.40至0.81; 95％CI，0.21至1.29），6- 1个月的抗甲状腺球蛋白抗体（95％CI，0.02至0.26），1个月和3个月的甲状腺过氧化物酶抗体（95％CI，0.02至0.22; 95％CI，0.17至0.43）和1天，1和消融后的3个月促甲状腺激素受体抗体（95％CI，0.10至0.43; 95％CI，0.00至0.30; 95％CI，0.13至0.36）。从长期来看，这六个指标没有发现统计学上的显着差异。亚组分析的结果与汇总结果相似。

结论

基于能量的消融更可能对甲状腺功能和抗体产生负面影响，并在短期内导致Tg水平短暂升高。但是，大多数患者在长期随访中不会出现任何甲状腺功能异常。