Abstract

Background

Radiofrequency ablation (RFA) has been recommended as the treatment for benign thyroid nodules (BTNs) by some guidelines. However, detailed follow-up instructions for thyroid function about the timing and affected populations after RFA are lacked due to insufficient researches. This 12-month prospective study aimed to evaluate the incidence and risk factors of thyroid dysfunction at different time points after RFA, especially within 1 week that previous studies didn’t concern.

Methods

Seventy-five euthyroid patients who underwent RFA for symptomatic BTNs were enrolled (ChiCTR-INR-16007884). The incidence of thyroid dysfunction within 1 week, at 1, 6, and 12 months after RFA was evaluated. The risk factors for different types of thyroid dysfunction in the different terms were further analyzed.

Results

Within 1 week after RFA, the incidence of thyroid dysfunction was as high as 36.00% unexpectedly, and only overt thyrotoxicosis and subclinical thyrotoxicosis occurred, which were significantly associated with the low-normal baseline thyrotropin (TSH) level (p = 0.001) and high ablation volume ratio (p = 0.008). From 1 to 12 months (the long term), the incidence dropped significantly and remained low (8.00–12.00%); and thyroid dysfunction presented as overt thyrotoxicosis, subclinical thyrotoxicosis, and subclinical hypothyroidism. The long-term thyrotoxicosis group had more cases with diabetes and lower baseline TSH levels. The long-term subclinical hypothyroidism group had more cases with positive thyroid peroxidase antibodies, higher baseline TSH levels, and higher ablation volume ratios.

Conclusions

After the RFA of BTNs, thyroid dysfunction was more likely to occur within 1 week and in populations with risk factors.

中文翻译：

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甲状腺良性结节射频消融术后甲状腺功能障碍：更可能发生在一周内和高危人群

摘要

背景

一些指南推荐射频消融 (RFA) 作为良性甲状腺结节 (BTN) 的治疗方法。然而，由于研究不足，缺乏关于RFA后时间和受影响人群的甲状腺功能的详细随访说明。这项为期 12 个月的前瞻性研究旨在评估 RFA 后不同时间点甲状腺功能障碍的发生率和危险因素，尤其是在先前研究未关注的 1 周内。

方法

招募了 75 名因有症状的 BTN 接受 RFA 的甲状腺功能正常的患者 (ChiCTR-INR-16007884)。评估 RFA 后 1 周内、1、6 和 12 个月时甲状腺功能障碍的发生率。进一步分析了不同术语中不同类型甲状腺功能障碍的危险因素。

结果

RFA 术后 1 周内，甲状腺功能障碍的发生率出乎意料地高达 36.00%，仅出现明显的甲状腺毒症和亚临床甲状腺毒症，这与正常低水平的基线促甲状腺激素（TSH）水平（p  =0.001）和高水平显着相关。消融体积比（p = 0.008）。1-12个月（长期），发病率显着下降并保持在较低水平（8.00-12.00%）；甲状腺功能障碍表现为明显的甲状腺毒症、亚临床甲状腺毒症和亚临床甲状腺功能减退症。长期甲状腺毒症组有更多的糖尿病病例和较低的基线 TSH 水平。长期亚临床甲减组的甲状腺过氧化物酶抗体阳性、基线 TSH 水平较高和消融体积比较高的病例较多。

结论

BTNs RFA后，甲状腺功能障碍更可能在1周内和有危险因素的人群中发生。