Radiofrequency ablation for benign thyroid nodule treatment: New solution in our center

Comparison of ultrasound-guided microwave ablation, laser ablation, and radiofrequency ablation for the treatment of elderly patients with benign thyroid nodules: A meta-analysis

BACKGROUND

A new minimally invasive technique, ultrasound-guided thermal ablation has become one of the treatment methods for benign thyroid nodules. This study aims to evaluate the efficacy and safety of laser ablation (LA), radiofrequency ablation (RFA), and microwave ablation (MWA) in the treatment of elderly patients with benign thyroid nodules.

METHODS

PubMed, Web of Science, and Cochrane Library were searched for qualified randomized controlled studies (RCTs) issued from establishing databases to March 2022. After screening and evaluating the article quality, the data on nodular volume reduction rate (VRR) and the incidence of complications after thermal ablation were extracted and analyzed by RevMan 5.3 and Stata l4.0.

RESULTS

The meta-analysis included seven articles with 3055 participants. We found that LA, RFA, and MWA could markedly reduce the volume of benign thyroid nodules. LA was superior to RFA and MWA in reducing the volume of benign thyroid nodules in 6 months of follow-up (all P < 0.05). LA, RFA, and MWA can be safely implemented in patients with benign thyroid nodules. The incidence of significant complications after the RFA group was enhanced compared with that in the MWA (P < 0.05), and the incidence of secondary complications after RFA was slightly higher than that of LA (P < 0.05).

CONCLUSION

LA, RFA, and MWA can markedly reduce the volume of benign thyroid nodules in elderly patients and can safely treat benign thyroid nodules.

The Role of Blood Microbiome in the Development of Thyroid Cancer in Breast Cancer Survivors

Patients diagnosed with breast cancer are likely to be diagnosed with thyroid cancer as a second primary cancer. Similarly, patients with thyroid cancer are likely to develop breast cancer. In this study, we found an association between these two types of cancers in the microbiomes of patients with breast cancer. Blood samples were collected from 96 patients with breast cancer, their bacterial extracellular vesicles were isolated, and their microbiomes were analyzed. After microbiome analysis, researchers performed thyroid function tests, estrogen levels, and thyroid ultrasound results of these patients, and the relationships among these parameters were analyzed. Based on the thyroid ultrasonography results, differences in the microbiome were confirmed in the normal, cyst, nodule, and thyroid lobectomy groups. We investigated the microbiome differences between normal thyroid and thyroid cancer. In particular, the abundance of the genus Bacillus is related to estrogen levels, which could affect thyroid abnormalities and increase thyroid-stimulating hormone levels. This study explains the causes of thyroid cancer in patients with breast cancer using microbiomes and serological tests for thyroid hormones and estrogen. These can be used as basic data for preventing thyroid cancer in patients with breast cancer.

Risk factors of recurrent thyroid nodules after radiofrequency ablation

Objective

To investigate the risk factors of thyroid nodule recurrence after radiofrequency ablation (RFA). METHODS The medical record information of 120 patients with thyroid nodules admitted to our hospital from June 2019 to April 2022 was retrospectively analysed. All participants received RFA treatment. According to the results of the postoperative thyroid ultrasound examination (USG), the patients were divided into the recurrence group (R, N=16) and the non-recurrence group (NR, N=104). Binary logistic regression analysis was performed to identify the independent risk factors of thyroid nodule recurrence after RFA. The receiver operating characteristic (ROC) curve was used to analyse the value of the forecast of each independent factor and combined model for thyroid nodule recurrence after RFA.

Results

During the follow-up period, 16 patients recurred, and the recurrence rate was 13.33%. Univariate regression analysis showed that whether the nodules are solitary (WNS), nodule diameter (ND), the degree of risk of nodular location (DRN), recurrent laryngeal nerve (RLN) injury were associated with thyroid nodule recurrence after RFA (P<0.05). Binary logistic regression analysis showed that WNS, ND, DRN and RLN injury were independent risk factors for the recurrence of thyroid nodules after RFA (P<0.05). ROC analysis of independent factors and combined model showed that solitary nodules, nodule diameter and nodule location risk degree had diagnostic value, while RLN injury had no predictive value. The combined model is more predictive than the independent factors. Conclusions: The risk factors of recurrent thyroid nodules after radiofrequency ablation are related to WNS, ND, DRN and so on, which should be paid attention to and preventive measures should be taken.