Effect of different ultrasound-guided ablation on the volume reduction rate and recurrence rate of benign thyroid nodules

doi:10.3877/cma.j.issn.1674-3946.2025.01.022.

Abstract

Abstract:

Objective

To investigate the effects of different ultrasound-guided ablation on the volume reduction rate and recurrence rate of benign thyroid nodules （BTN）.

Methods

The clinical data of 280 BTN from 227 patients from January 2019 to January 2023 were retrospectively analyzed.136 BTN from 115 patients admitted for radiofrequency ablation （RFA） treatment from January 2019 to January 2021 were included in the radiofrequency group.144 BTN from 112 patients admitted to hospital for microwave ablation（MWA） from February 2021 to January 2023 were included in the microwave group and analyzed by SPSS 22.0 statistical software.Measurement data such as nodule volume and reduction rate of patients in the two groups were expressed with（x ± s）， and independent sample t test was used.The data of immediate ablation， recurrence rate and complications after 1 year of follow-up were analyzed by χ² test.P＜0.05 indicated that the difference was statistically significant.

Results

The immediate ablation rates of 1 to 2cm and 3 to 5cm BTN in microwave group were 96.2% and 67.9%， significantly higher than those in radiofrequency group （79.7% and 41.8%，P＜0.05）.At each time point after operation， the nodule volume in both groups was significantly decreased，and the microwave group was significantly smaller than the radiofrequency group （P＜0.05）.The reduction rate of nodules in both groups was significantly higher than that before surgery， and the microwave group was significantly higher than the radiofrequency group （P＜0.05）.After 1 year follow-up， the recurrence rate of nodules in microwave group was significantly lower than that in radiofrequency group （P＜0.05）.During the follow-up period and 12 months after treatment， there were no significant differences in the rate of immediate ablation of nodules ＜1cm in diameter， the incidence of complications and aesthetic scores between the two groups （P＞0.05）.

Conclusion

Ultrasound-guided MWA ablation of BTN can reduce its volume and increase the reduction rate significantly， which can effectively reduce the recurrence rate.

Key words: Benign Thyroid Nodules, Different Ablations, Volume Reduction Rate, Recurrence Rate

Tianwei Xie, Yufan Pang, Li Wu. Effect of different ultrasound-guided ablation on the volume reduction rate and recurrence rate of benign thyroid nodules[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(01): 80-83.

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Figures/Tables 4

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	结节位置（例）A/B	结节形态（例）C/D	结节直径（cm）＜1/1～2/3～5
悬吊组	115	45.5±3.5	31/84	116/20	75/61	10/59/67
传统组	112	46.3±4.0	35/77	125/19	81/63	8/52/84
t/χ²值		1.604	0.507	0.133	0.034	2.351
P值		0.109	0.476	0.715	0.853	0.309

组别	例数	年龄（岁， $\overset{ˉ}{x}$ ±s）	性别（例）男/女	结节位置（例）A/B	结节形态（例）C/D	结节直径（cm）＜1/1～2/3～5
悬吊组	115	45.5±3.5	31/84	116/20	75/61	10/59/67
传统组	112	46.3±4.0	35/77	125/19	81/63	8/52/84
t/χ²值		1.604	0.507	0.133	0.034	2.351
P值		0.109	0.476	0.715	0.853	0.309

组别	例数	结节直径（cm）	结节数（枚）	即刻消融结节率［枚（%）］
射频组	115	＜1	10	10（100.0）
		1～2	59	47（79.7）
		3～5	67	28（41.8）
微波组	112	＜1	8	8（100.0）
		1～2	52	50（96.2）^a
		3～5	84	57（67.9）^a

组别	例数	时间	结节数（枚）	体积（ml， $\overset{ˉ}{x}$ ±s）	缩减率（%， $\overset{ˉ}{x}$ ±s）	1年后消融成功结节数（枚）	1年后结节复发率［枚（%）］
		T0	136	8.3±1.2	-
		T1	41	4.1±1.0^b	51.0±6.8
射频组	115	T3	32	3.2±1.0^b	61.4±6.9	121	41（33.9）
		T6	18	2.0±1.0^b	75.9±7.1
		T12	15	1.1±0.9^b	87.0±8.0
		T0	144	8.7±2.1	-
		T1	10	3.6±1.6^ab	58.8±6.2^a
微波组	112	T3	8	2.8±1.0^ab	68.1±7.4^a	142	25（17.6）^a
		T6	6	1.4±1.1^ab	84.3±5.9^a
		T12	2	0.4±0.7^ab	94.9±8.0^a

组别	例数	时间	结节数（枚）	体积（ml， $\overset{ˉ}{x}$ ±s）	缩减率（%， $\overset{ˉ}{x}$ ±s）	1年后消融成功结节数（枚）	1年后结节复发率［枚（%）］
		T0	136	8.3±1.2	-
		T1	41	4.1±1.0^b	51.0±6.8
射频组	115	T3	32	3.2±1.0^b	61.4±6.9	121	41（33.9）
		T6	18	2.0±1.0^b	75.9±7.1
		T12	15	1.1±0.9^b	87.0±8.0
		T0	144	8.7±2.1	-
		T1	10	3.6±1.6^ab	58.8±6.2^a
微波组	112	T3	8	2.8±1.0^ab	68.1±7.4^a	142	25（17.6）^a
		T6	6	1.4±1.1^ab	84.3±5.9^a
		T12	2	0.4±0.7^ab	94.9±8.0^a

组别	例数	喉返神经损伤	渗血	血肿
射频组	115	2（1.7）	3（2.6）	7（6.1）
微波组	112	3（2.7）	1（0.9）	4（3.6）
χ²值		0.232	0.965	0.779
P值		0.681	0.622	0.378

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