制定化疗方案的重要参考

看懂术后病理,浸润肠壁程度、周边侵犯程度、淋巴结转移数量是肿瘤内科医生制定化疗方案的重要参考

  •  肠癌术后病理报告一般记载的项目内容大概如下;

术后病理是患者做完手术切除出来的身体组织做病理检测,得出各种对患者病情有指导意义的各种病理检测结果,是肿瘤内科医生做化疗方案的重要依据。根据6年群解答经验和研究超过1000张以上的术后病理报告,结合病理报告出来之后各省的专业肿瘤医院内科医生,针对各种病理结果而制定的化疗方案大体如下;

一、送检材料:如:直肠及肿物、吻合口近端切缘、吻合口远端切缘。

二、肉眼所见:

术后病理通常会描述肉眼所见的送检肠管;切除的肠管管长、肠管的周径或直径、距离肿瘤的上切缘和下切缘、肿瘤的大小、肿瘤是隆起型还是溃疡型、

  • 图像和镜下所见;如;癌组织有管状、腺泡状、或筛状结构组成,细胞异常明显,浸润生长等信息。
  • 病理诊断;

如直(结)肠癌根治标本;

  1. (直肠或结肠)早期癌或中期癌等;
  2. 组织学类型;管状腺癌、或粘液腺癌等;
  3. 分化程度;中低分化或中高分化等;
  4. 浸润深度:粘膜下层、浅肌层、深肌层、侵犯全层等;
  5. 脉管内癌栓:有或无;
  6. 神经侵犯;有或无;
  7. 切缘;送检的近端和远端切缘、环周切缘是否阳性;
  8. 淋巴结见转移癌如(1/15)表示切除15个淋巴结,其中一个阳性。

经验上各大专业肿瘤医院肿瘤内科医生注重的病理诊断项目的重要性排序大概如下:

1、肿瘤侵犯浸润深度;通常分为侵犯粘膜层、侵犯浅肌层、侵犯深肌层、侵犯浆膜层下脂肪、侵犯肠壁全层、侵犯浆膜层、侵犯浆膜层外脂肪。

  • 清除淋巴结阳性数目和清除淋巴结总数目,有些专业医院会分清除淋巴结总数目中来自于肠周第一站淋巴结数目和阳性数目,来自于肠系膜第二站淋巴结的数目和阳性淋巴结数目,来自于第三站淋巴结数目和阳性淋巴结数目。
  • 肠外癌结节数量多少枚和癌结节大小
  • 肿瘤属于那种性质的肿瘤,属于几级、分化程度属于高、中、低分化程度。
  • 检查脉管内是否有癌栓,神经束是否侵犯,这两个因素是否阳性指南列为高危因素;
  • 肠外血管是否被侵犯。

7、两端切缘和环周切缘一般都属于阴性,虽然是重要参考,但是阳性个案不多。

  • 经验上各大肿瘤医院肿瘤内科医生做化疗方案的依据因素大概如下:

经验上各大肿瘤医院的肿瘤内科医生一般见到下列几种因素的病情,通常会做肠癌一线药奥沙利铂+卡倍他滨片常规化疗方案中,最高的8个三周期疗程、或者12个两周期疗程。

  1. 肿瘤浸润深度达到1mm以上;接近浆膜层附近的;部分突破浆膜层、侵犯周边脂肪的;
  2. 肠周脂肪有癌结节的;
  3. 有淋巴结转移的;轻重分1-3个和3个以上;
  4. 属于粘液腺癌或者印戒淋巴癌的;
  5. 有神经侵犯或者脉管癌栓的;
  6. 淋巴结没有按照指南规定清除12个淋巴结的;
  7. 肿瘤比较大的;

经验上各大肿瘤医院的肿瘤内科医生一般见到下列几种因素的病情,通常会做肠癌一线药常规化疗中奥沙利铂+卡倍他滨片次高的6个三周期疗程。

  1. 肿瘤浸润深度达到深肌层的,一般在1mm以内的;
  2. 淋巴结没有转移或1个转移的;
  3. 肠外脂肪没有癌结节的;
  4. 属于一般腺癌的;
  5. 脉管癌栓和神经侵犯有一种侵犯的;
  6. 淋巴结没有按照指南规定清除12个淋巴结的;
  7. 肿瘤相对比较大的;

经验上各大肿瘤医院的肿瘤内科医生一般见到下列几种因素的病情,通常会做肠癌一线药常规化疗中的奥沙利铂+卡倍他滨片比较轻的4个三周期疗程或口服8个卡倍他滨片疗程。

  1. 肿瘤浸润深度达到浅肌层以下的;

2. 淋巴结没有转移的;

3. 肠外脂肪没有癌结节的;

4. 属于一般腺癌的;

5. 脉管内没癌栓和神经没有被侵犯的;

6. 淋巴结按照指南规定清除12个淋巴结的;

7. 肿瘤相对比较小的;

声明:

以上各种术后病理结果和肿瘤内科化疗医生制定的大致化疗方案的关系因素,纯粹是我根据6年来观察各大专业肿瘤医院肿瘤内科医生,制定的化疗方案轻重大概率跟上列因素相关的概率很高,结合自己的术后病理因素及化疗方案,和询问化疗医生时化疗医生的讲解综合得出,一个肿瘤内科医生大概制定化疗方案的依据因素。

任何化疗方案都要以专业医院肿瘤内科医生做出的化疗方案为主,上述经验之谈粗分类化疗方案种类,只作为患者或家属初步读懂病理内容,对肿瘤内科医生制定化疗方案的理解和跟医生的对话基础,和作为一般化疗科普知识的罗列,没有任何的专业研究依据,不可以作为任何患者化疗方案的制定依据。

分享此资料:

制定化疗方案的重要参考》有67个想法

  1. infusion cbd

    I like this site very much, Its a rattling nice post to read and get info . “Misogynist A man who hates women as much as women hate one another.” by H.L. Mencken.

    回复
  2. cbd vape

    Hello there! Do you know if they make any plugins to assist with SEO? I’m trying to get my blog to rank for some targeted keywords but I’m not seeing very good gains. If you know of any please share. Kudos!

    回复
  3. achat cbd

    I like what you guys are up also. Such intelligent work and reporting! Carry on the excellent works guys I have incorporated you guys to my blogroll. I think it will improve the value of my website 🙂

    回复
  4. Boostaro

    I’ll right away grab your rss as I can’t find your e-mail subscription link or e-newsletter service. Do you have any? Kindly let me know in order that I could subscribe. Thanks.

    回复
  5. Zencortex

    I do agree with all the ideas you have presented in your post. They are very convincing and will definitely work. Still, the posts are very short for starters. Could you please extend them a bit from next time? Thanks for the post.

    回复
  6. Sugar defender review

    Hi there just wanted to give you a quick heads up. The words in your content seem to be running off the screen in Internet explorer. I’m not sure if this is a format issue or something to do with internet browser compatibility but I thought I’d post to let you know. The design look great though! Hope you get the issue fixed soon. Many thanks

    回复
  7. Puravive

    Hmm it appears like your site ate my first comment (it was extremely long) so I guess I’ll just sum it up what I submitted and say, I’m thoroughly enjoying your blog. I as well am an aspiring blog writer but I’m still new to the whole thing. Do you have any tips and hints for first-time blog writers? I’d certainly appreciate it.

    回复
  8. Java Burn

    Wow that was unusual. I just wrote an very long comment but after I clicked submit my comment didn’t show up. Grrrr… well I’m not writing all that over again. Regardless, just wanted to say excellent blog!

    回复
  9. social media hackers for hire

    My developer is trying to convince me to move to .net from PHP. I have always disliked the idea because of the expenses. But he’s tryiong none the less. I’ve been using WordPress on several websites for about a year and am nervous about switching to another platform. I have heard fantastic things about blogengine.net. Is there a way I can import all my wordpress content into it? Any kind of help would be really appreciated!

    回复
  10. serolean review

    Sweet blog! I found it while browsing on Yahoo News. Do you have any suggestions on how to get listed in Yahoo News? I’ve been trying for a while but I never seem to get there! Thanks

    回复
  11. Sight Care review

    Only wanna remark on few general things, The website pattern is perfect, the subject matter is really superb. “War is much too serious a matter to be entrusted to the military.” by Georges Clemenceau.

    回复
  12. Renew

    Thanks for sharing excellent informations. Your website is very cool. I am impressed by the details that you have on this blog. It reveals how nicely you perceive this subject. Bookmarked this website page, will come back for extra articles. You, my pal, ROCK! I found just the information I already searched everywhere and just couldn’t come across. What a perfect website.

    回复
  13. basics

    Good blog! I really love how it is simple on my eyes and the data are well written. I am wondering how I could be notified whenever a new post has been made. I’ve subscribed to your RSS which must do the trick! Have a great day!

    回复
  14. cbd gummibärchen arthrose

    Hey there! This post couldn’t be written any better! Reading through this post reminds me of my good old room mate! He always kept chatting about this. I will forward this page to him. Pretty sure he will have a good read. Thanks for sharing!

    回复
  15. cbd suisse

    I was very pleased to find this web-site.I wanted to thanks for your time for this wonderful read!! I definitely enjoying every little bit of it and I have you bookmarked to check out new stuff you blog post.

    回复
  16. roket slot

    Hello my family member! I want to say that this article is awesome, great written and come with approximately all important infos. I would like to peer more posts like this .

    回复
  17. Fitspresso

    Wow! This can be one particular of the most useful blogs We have ever arrive across on this subject. Actually Magnificent. I am also a specialist in this topic so I can understand your hard work.

    回复
  18. Glucofreedom

    Normally I do not read article on blogs, but I wish to say that this write-up very pressured me to take a look at and do it! Your writing taste has been surprised me. Thanks, quite great article.

    回复
  19. Fitspresso review

    I’m writing to make you be aware of of the excellent experience my friend’s girl encountered visiting your web site. She noticed a good number of pieces, with the inclusion of how it is like to have an amazing coaching nature to get folks very easily learn about several very confusing subject areas. You truly did more than readers’ expectations. Many thanks for churning out such valuable, trusted, edifying not to mention unique guidance on the topic to Mary.

    回复
  20. Lottery Defeater

    Good post. I study one thing more challenging on different blogs everyday. It will at all times be stimulating to read content material from other writers and practice slightly something from their store. I’d want to use some with the content on my blog whether you don’t mind. Natually I’ll provide you with a hyperlink on your web blog. Thanks for sharing.

    回复
  21. Fitspresso

    I do enjoy the way you have framed this issue plus it does indeed give me personally a lot of fodder for thought. Nonetheless, through everything that I have witnessed, I simply hope when the opinions pack on that individuals continue to be on issue and in no way embark upon a tirade associated with the news du jour. Anyway, thank you for this fantastic piece and whilst I do not necessarily agree with the idea in totality, I respect the viewpoint.

    回复
  22. Provadent

    I just couldn’t depart your website before suggesting that I extremely enjoyed the standard information a person provide for your visitors? Is going to be back often in order to check up on new posts

    回复
  23. Fitspresso review

    I haven?¦t checked in here for some time since I thought it was getting boring, but the last several posts are great quality so I guess I?¦ll add you back to my daily bloglist. You deserve it my friend 🙂

    回复
  24. cbd liquids

    It is truly a nice and helpful piece of information. I am satisfied that you just shared this helpful info with us. Please keep us informed like this. Thanks for sharing.

    回复
  25. Cellucare

    We are a group of volunteers and starting a new scheme in our community. Your site offered us with valuable info to work on. You have done a formidable job and our entire community will be thankful to you.

    回复
  26. hire a hacker uk

    Hiya, I am really glad I’ve found this info. Today bloggers publish just about gossips and web and this is really frustrating. A good site with interesting content, this is what I need. Thanks for keeping this website, I will be visiting it. Do you do newsletters? Can not find it.

    回复
  27. nervo vive reviews

    A person necessarily assist to make severely articles I might state. This is the first time I frequented your website page and to this point? I surprised with the research you made to create this particular put up extraordinary. Fantastic activity!

    回复
  28. cbd trim kaufen

    Generally I do not learn post on blogs, but I would like to say that this write-up very forced me to take a look at and do it! Your writing taste has been surprised me. Thank you, very nice post.

    回复

发表回复

您的电子邮箱地址不会被公开。 必填项已用 * 标注