多参数超声引导下经皮微波消融治疗功能亢进性甲状旁腺病变用于原发性甲状旁腺功能亢进症：系统评价与荟萃分析
Percutaneous microwave ablation of hyperfunctioning parathyroid lesions under multiparametric ultrasound guidance for primary hyperparathyroidism: a systematic review and meta-analysis.
文献信息
| PMID | 42835108 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Mei Kei Lum |
| 作者单位 | Department of Hospital Surgery No. 1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation, Moscow, Russia. |
| 期刊 | Frontiers in oncology |
| SCI 分区 | Q2 |
| IF | 3.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 多参数超声（MPUS）引导下经皮微波消融（MWA）已成为原发性甲状旁腺功能亢进症（PHPT）的一种微创治疗选择，但关于纵向生化结局和安全性的汇总证据仍然有限。
目的： 本荟萃分析旨在评估超声引导下经皮MWA治疗PHPT的疗效和安全性。
方法： 遵循PRISMA指南，从五个电子数据库中检索符合条件的队列研究。通过随机效应模型计算汇总治愈率、完整甲状旁腺激素（iPTH）、血清钙和磷的系列变化、总体并发症发生率以及腺瘤体积缩小情况。进行留一法敏感性分析以评估汇总估计值的稳健性。
结果： 共纳入9个队列，纳入355例PHPT患者。技术成功率为100%。汇总临床治愈率在6个月时达到86.0%，12个月时为82.0%，在最后一次可获得的随访时为75.0%。血清钙和iPTH在所有时间点均显著下降，血清磷升高。汇总的患者水平总体并发症发生率为11.0%，其中短暂性声音嘶哑和短暂性低钙血症是最常报告的事件特异性并发症，而永久性喉返神经损伤罕见。
结论： 当前证据提示，超声引导下经皮MWA可能是经过适当选择的PHPT患者的一种微创治疗选择，可提供可接受的中期生化改善，且安全性特征可耐受。
系统评价注册： https://www.crd.york.ac.uk/PROSPERO/view/CRD42025644973，标识符CRD42025644973。
英文摘要
BACKGROUND: Multiparametric ultrasound (MPUS)-guided percutaneous microwave ablation (MWA) has emerged as a minimally invasive treatment option for primary hyperparathyroidism (PHPT), but pooled evidence on longitudinal biochemical outcomes and safety remains limited.
OBJECTIVE: This meta-analysis aimed to evaluate the efficacy and safety of percutaneous MWA performed under ultrasound guidance for PHPT.
METHODS: Following PRISMA guidelines, eligible cohort studies were retrieved from five electronic databases. Pooled cure rates, serial changes in intact parathyroid hormone (iPTH), serum calcium and phosphorus, overall complication rates, and adenoma volume reduction were calculated via random-effects models. Leave-one-out sensitivity analyses were performed to assess the robustness of the pooled estimates.
RESULTS: Nine cohorts enrolling 355 PHPT patients were included. Technical success was 100%. Pooled clinical cure rates reached 86.0% at 6 months, 82.0% at 12 months, and 75.0% at the last available follow-up. Serum calcium and iPTH declined significantly, and serum phosphorus rose across all time points. The pooled patient-level overall complication rate was 11.0%, with transient hoarseness and transient hypocalcemia being the most commonly reported event-specific complications, whereas permanent recurrent laryngeal nerve injury was rare.
CONCLUSION: Current evidence suggests that percutaneous MWA performed under ultrasound guidance may be a minimally invasive treatment option for appropriately selected patients with PHPT, providing acceptable mid-term biochemical improvement with a tolerable safety profile.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025644973, identifier CRD42025644973.