甲状腺癌可不可以进行射频消融治疗 雷志锴 浙江大学医学院附属杭州市第一人民医院

甲状腺癌可不可以进行射频消融治疗 雷志锴 浙江大学医学院附属杭州市第一人民医院
射频消融治疗技术，近几年发展也是非常热的，但是良性的结节，目前来讲应该是没有争议的，良性的结节是可以进行甲状腺射频消融治疗的，因为良性的结节，做消融治疗效果也是非常的好，对还患者来讲应该说损伤比较小，这个技术大家也乐意接受，在我们业界，就我们讲的包括我们的外科甲状腺，这种相关的科室也达成了相关的共识，对良性的结节做消融是没有问题的，但是我们比较关心的问题就是，这个甲状腺癌可不可以做消融，这个问题要从综合来看，因为甲状腺癌你可能是很早期的，比如讲只有0.2、0.3，因为现在的超声技术也是非常的好，0.2、0.3的这些结节也可以发现的了，所以一些低于0.3、0.2的，甚至0.5以下的，甚至一公分以下的这些微小癌的话，如果位置好，里面又没有钙化，甲状腺的包膜也没有侵犯，颈部也没有任何的，转移性的淋巴结的情况下，是可以去做消融治疗的，但是对于一些甲状腺癌，如果它的包膜已经侵犯了，或者是淋巴结已经侵犯了，或者说它虽然小，但是也侵犯了周围的一些重要的脏器，或者说靠近甲状腺的背侧、靠近气管、靠近背侧的包膜，这些结节的话，我们不主张去做射频消融治疗，还有里面一些微钙化，或者说粗大的钙化的这些微小癌的话，我们也是不主张去做射频消融治疗的，所以对于得了甲状腺癌，需不需要射频消融治疗需要我们甲状腺的相关的科室，多学科进行一个评估，综合评估之后在决定需不需要做甲状腺射频消融治疗，是这么个情况。

Can thyroid cancer be treated by radiofrequency ablation
Radiofrequency ablation, In recent years, the development is also very hot, But benign nodules, At present, there should be no dispute, Benign nodules can be treated by radiofrequency ablation, Because of benign nodules, The effect of ablation is also very good, For patients, it should be said that the damage is relatively small, We are willing to accept this technology, In our industry, As far as we're concerned, including our surgical thyroid, The relevant departments also reached a consensus, There is no problem in ablation of benign nodules, But our concern is, Can this thyroid cancer be ablated, From a comprehensive perspective, Because thyroid cancer can be very early, For example, only 0.2, 0.3, Because the current ultrasound technology is also very good, The nodules of 0.2 and 0.3 can also be found, So some below 0.3, 0.2, Even less than 0.5, Even if these tiny cancers are less than one centimeter, If the position is good, There's no calcification in it, There was no invasion of the thyroid capsule, There's nothing in the neck, In the case of metastatic lymph nodes, You can do ablation, But for some thyroid cancers, If its envelope has been violated, Or the lymph nodes have been invaded, Or even though it's small, But it also invades some important organs around, Or the capsule near the back of the thyroid gland, near the trachea, near the back, In the case of these nodules, We don't advocate radiofrequency ablation, There are also some microcalcifications in it, Or, in the case of these tiny cancers, which are massive calcifications, We also don't advocate radiofrequency ablation, So for thyroid cancer, If we need radiofrequency ablation, we need our thyroid department, A multidisciplinary assessment, After the comprehensive evaluation, it is decided whether the thyroid radiofrequency ablation is needed, This is the case.