Retrospective Analysis Of Thyroid Nodules Surgical Treatments And Therapeutic Efficacy Evaluation Of Benign Thyroid Nodules Radiofrequency Ablation

Part One Analysis of Thyroid Nodules Surgical Treatments In 11 YearsObjectiveAnalyze the proportion of benign and malignant thyroid nodules that received surgical treatments and the trend of proportion change.Assess the pathological results of the malignant thyroid nodules.To describe the operation modes of the benign and malignant thyroid nodules.Materials and MethodsThe thyroid nodules patients that received surgical treatments from Jan,2004 to Dec,2014 were selected and collected from medical record department.Using ?2 trend test to analyze the annual proportion of the benign and malignant thyroid nodules.Adopt the descriptive statistics to analyze the varied thyroid operation modes according to theirs benign or malignant diagnosis.ResultsFrom 2004 to 2014,the proportion of benign thyroid nodules received surgical treatments decreased from 89.50%to 56.90%,on the contrary,that of malignant ones increased from 10.50%to 43.10%(P<0.05).The pathological results of the malignant thyroid nodules were papillary carcinoma(96.2%),follicular carcinoma(2.7%),medullary carcinoma(1.0%)and undifferentiated carcinoma(0.1%)respectively.Bilateral subtotal thyroidectomy(31.9%)was the most common benign thyroid nodules operation mode.Radical resection of thyroid cancer(50.1%)was the most common malignant thyroid nodules operation mode.ConclusionsThe annual proportion of benign thyroid nodules that received surgical treatments had decreased through years,while the annual proportion of malignant ones had increased,mainly due to the acknowledge of thyroid nodule disease,screening of thyroid and update of international guideline.Part Two Assessment of the Ultrasound Guided Benign Thyroid Nodules Radiofrequency Ablation Influence on Thyroid Function and Thyroid Autoimmune IndexesObjectiveTo access how the thyroid function and thyroid autoimmune indexes had changed after the ultrasound guided radiofrequency ablation(RFA)of benign thyroid nodules,and to evaluate the effect RFA had on thyroid nodules volume reduction.Materials and MethodsSelect patients that suffer from solid or approximately solid(>50%)and benign thyroid nodules and whose thyroid function were normal.After benign thyroid RFA therapy,patients returned and had follow-up visits of ultrasound and thyroid indexes on the 1st month,3rd month,6th month and 12th month.ResultsAfter 3 months,6 months and 12 months TSH levels had elevated,and the incidence of subclinical hypothyroidism after RFA was 5.9%(after 3 months),2.9%(after 6 months)and 1.2%(after 12 months).For those that TG was normal before RFA,99.96?99.99%of the patients TG level maintained normal after RFA.While among the patients whose TG level was already higher than normal range before RFA,it was found that 62.5%(after 1 months),70.0%(after 3 months),79.4%(after 6 months)and 73.9%(after 12 months)of them had normal TG level.Compared to the TGAb level before RFA,TGAb level elevated 1.70%,13.27%,4.26%and 6.27%respectively during 1 months,3 months,6 months and 12 months follow-up.Among the patients whose TGAb level was normal before RFA,13.0%(after 3 months)and 11.4%(after 6 months)of them,TGAb elevated and became higher than normal.TPOAb level elevated 6.28%and 7.04%respectively during 3 months and 6 months follow-up.Among the patients whose TPOAb level was normal before RFA,1.1%(after 3 months)and 1.3%(after 6 months)of them,TPOAb elevated and became higher than normal.The volume reduction rate of thyroid nodule was 38.23%,59.98%,70.28%and 76.44%after 1 months,3 months,6 months and 12 months of RFA respectively.ConclusionsThere was not vital influence on thyroid function and autoimmune thyroid indexes after RFA of benign thyroid nodules,while the reduction of thyroid nodules was significant.