胃癌转移卵巢癌,诊断为“转移性印戒细胞型粘液腺癌(卵巢克鲁根勃瘤)”
\u9690\u6027\u80c3\u764c\u8981\u5982\u4f55\u8bca\u65ad\u5b9e\u9a8c\u5ba4\u68c0\u67e5\uff1a\u65e9\u671f\u8840\u68c0\u591a\u6b63\u5e38\uff0c\u4e2d\u3001\u665a\u671f\u53ef\u6709\u4e0d\u540c\u7a0b\u5ea6\u7684\u8d2b\u8840\u3001\u7caa\u4fbf\u6f5c\u8840\u8bd5\u9a8c\u9633\u6027\u3002\u76ee\u524d\u5c1a\u65e0\u5bf9\u4e8e\u80c3\u764c\u8bca\u65ad\u7279\u5f02\u6027\u8f83\u5f3a\u7684\u80bf\u7624\u6807\u8bb0\u7269\uff0cCEA\u3001CA50\u3001CA72-4\u3001CA19-9\u3001CA242\u7b49\u591a\u4e2a\u6807\u8bb0\u7269\u7684\u8fde\u7eed\u76d1\u6d4b\u5bf9\u4e8e\u80c3\u764c\u7684\u8bca\u7597\u548c\u9884\u540e\u5224\u65ad\u6709\u4e00\u5b9a\u4ef7\u503c\u3002
\u5f71\u50cf\u5b66\u68c0\u67e5\uff1a
\uff081\uff09\u4e0a\u6d88\u5316\u9053X\u7ebf\u94a1\u9910\u9020\u5f71\uff1a\u6709\u52a9\u4e8e\u5224\u65ad\u75c5\u7076\u8303\u56f4\u3002\u4f46\u65e9\u671f\u75c5\u53d8\u4ecd\u9700\u7ed3\u5408\u80c3\u955c\u8bc1\u5b9e\uff1b\u8fdb\u5c55\u671f\u80c3\u764c\u4e3b\u8981X\u7ebf\u5f81\u8c61\u6709\u9f9b\u5f71\u3001\u5145\u76c8\u7f3a\u635f\u3001\u7c98\u819c\u76b1\u895e\u6539\u53d8\u3001\u8815\u52a8\u5f02\u5e38\u53ca\u6897\u963b\u6027\u6539\u53d8\u3002
\uff082\uff09\u589e\u5f3a\u578bCT\uff08\u7535\u8111\u65ad\u5c42\u626b\u63cf\u8bbe\u5907\uff09\u53ef\u4ee5\u6e05\u6670\u663e\u793a\u80c3\u764c\u7d2f\u53ca\u80c3\u58c1\u7684\u8303\u56f4\u3001\u4e0e\u5468\u56f4\u7ec4\u7ec7\u7684\u5173\u7cfb\u3001\u6709\u65e0\u8f83\u5927\u7684\u8179\u8154\u76c6\u8154\u8f6c\u79fb\u3002
\uff083\uff09MRI\uff08\u78c1\u5171\u632f\u663e\u50cf\uff09\u5728\u5224\u65ad\u764c\u7076\u8303\u56f4\u65b9\u9762\u53ef\u63d0\u4f9b\u53e6\u4e00\u79cd\u4fe1\u606f\uff0cCT\u9020\u5f71\u5242\u8fc7\u654f\u8005\u6216\u5176\u4ed6\u5f71\u50cf\u5b66\u68c0\u67e5\u6000\u7591\u8f6c\u79fb\u8005\u53ef\u4f7f\u7528\u6b64\u68c0\u67e5\uff0cMRI\u6709\u52a9\u4e8e\u5224\u65ad\u8179\u819c\u8f6c\u79fb\u72b6\u6001\uff0c\u53ef\u914c\u60c5\u4f7f\u7528\u3002
\uff084\uff09PET-CT\u626b\u63cf\uff08\u6b63\u7535\u5b50\u53d1\u5c04\u65ad\u5c42\u626b\u63cf\u8bbe\u5907\u4e0e\u7535\u8111\u65ad\u5c42\u626b\u63cf\u8bbe\u5907\u5408\u4e8c\u4e3a\u4e00\u7684\u8bbe\u5907\uff09\u5bf9\u5224\u65ad\u662f\u5426\u662f\u80c3\u764c\u7ea6\u670980%\u4ee5\u4e0a\u7684\u51c6\u786e\u6027\uff08\u5370\u6212\u7ec6\u80de\u764c\u548c\u7c98\u6db2\u817a\u764c\u51c6\u786e\u6027\u7ea650%\uff09\uff0c\u5e76\u53ef\u4e86\u89e3\u5168\u8eab\u6709\u65e0\u8f6c\u79fb\u7076\uff0c\u6ca1\u6709\u75db\u82e6\uff0c\u4f46\u8d39\u7528\u6602\u8d35\u3002 \u672f\u524d\u663e\u5f71\u7684\u80c3\u764c\u672f\u540e\u53ef\u9760\u6b64\u65b9\u4fbf\u5730\u8ffd\u8e2a\u6709\u65e0\u80c3\u764c\u590d\u53d1\u3002
\uff085\uff09\u80c3\u955c\u6216\u8179\u8154\u955c\u5176\u8d85\u58f0\uff1a
\u2460\u53ef\u6d4b\u91cf\u764c\u7076\u8303\u56f4\u53ca\u521d\u6b65\u8bc4\u4f30\u6dcb\u5df4\u7ed3\u8f6c\u79fb\u60c5\u51b5\uff0c\u6709\u52a9\u4e8e\u672f\u524d\u4e34\u5e8a\u5206\u671f\uff0c\u4ee5\u4fbf\u9009\u62e9\u7597\u6cd5\u53ca\u5224\u65ad\u7597\u6548\u3002
\u2461\u80c3\u955c\u75c5\u7406\u6d3b\u68c0\uff08\u53d6\u6d3b\u7ec4\u7ec7\u8fdb\u884c\u75c5\u7406\u68c0\u9a8c\uff09\u660e\u786e\u4e3a\u80c3\u764c\u8005\uff0c\u53ef\u4f5c\u80c3\u955c\u955c\u8d85\u58f0\u68c0\u67e5\u786e\u5b9a\u5176\u662f\u5426\u4e3a\u65e9\u671f\u6216\u8fdb\u5c55\u671f\uff0c\u5355\u7eaf\u80c3\u955c\u68c0\u67e5\u6709\u65f6\u96be\u4ee5\u533a\u5206\u80c3\u764c\u7684\u65e9\u665a\u671f\u3002
\u2462\u80c3\u955c\u53d1\u73b0\u53ef\u7591\u80c3\u764c\u4f46\u75c5\u7406\u6d3b\u68c0\u53c8\u4e0d\u80fd\u786e\u8bca\uff0c\u53ef\u7528\u8d85\u58f0\u5185\u955c\u5224\u65ad\u800c\u4e0d\u9700\u8981\u75c5\u4eba\u53cd\u590d\u80c3\u955c\u68c0\u67e5\u6d3b\u68c0\u3002
\u2463\u672f\u524d\u5404\u79cd\u5f71\u50cf\u68c0\u67e5\u6000\u7591\u6dcb\u5df4\u7ed3\u5e7f\u6cdb\u589e\u5927\u8005\u6216\u6000\u7591\u4fb5\u72af\u91cd\u8981\u810f\u5668\u53ef\u80fd\u4e0d\u80fd\u5207\u9664\u8005\uff0c\u82e5\u6761\u4ef6\u8bb8\u53ef\uff0c\u53ef\u884c\u8179\u8154\u955c\u8d85\u58f0\u68c0\u67e5\u4e86\u89e3\u662f\u5426\u764c\u7076\u4e0e\u810f\u5668\u95f4\u6709\u754c\u9650\u4ee5\u4fbf\u5207\u9664\u3001\u6dcb\u5df4\u7ed3\u662f\u5426\u8f6c\u79fb\u878d\u5408\u5230\u65e0\u6cd5\u5207\u9664\u7684\u7a0b\u5ea6\u3001\u54ea\u4e9b\u6dcb\u5df4\u7ed3\u6709\u53ef\u80fd\u8f6c\u79fb\u3002
\u5185\u7aa5\u955c\u68c0\u67e5\uff1a
\u2460\u80c3\u955c\u68c0\u67e5\uff0c\u53ef\u53d1\u73b0\u65e9\u671f\u80c3\u764c\uff0c\u9274\u522b\u826f\u6076\u6027\u6e83\u75a1\uff0c\u786e\u5b9a\u80c3\u764c\u7684\u7c7b\u578b\u548c\u75c5\u7076\u8303\u56f4\u3002\u53d1\u73b0\u80c3\u6e83\u75a1\u6216\u840e\u7f29\u6027\u80c3\u708e\uff0c\u8981\u75c5\u7406\u6d3b\u68c0\u8bc4\u4f30\u5176\u7ec6\u80de\u5f02\u578b\u589e\u751f\u7a0b\u5ea6\uff0c\u91cd\u5ea6\u5f02\u578b\u589e\u751f\uff08\u4e0d\u5178\u578b\u589e\u751f\uff09\u8005\u9700\u8981\u6309\u65e9\u671f\u764c\u5bf9\u5f85\u3002
\u2461\u8179\u8154\u955c\u68c0\u67e5\uff0c\u6709\u6761\u4ef6\u7684\u533b\u9662\u53ef\u901a\u8fc7\u6b64\u68c0\u67e5\u8fbe\u5230\u7c7b\u4f3c\u5256\u8179\u63a2\u67e5\u7684\u6548\u679c\uff0c\u53ef\u7ec6\u81f4\u4e86\u89e3\u764c\u7076\u4e0e\u5468\u56f4\u60c5\u51b5\uff0c\u5c24\u5176\u662f\u53ef\u53d1\u73b0\u8179\u819c\u6709\u65e0\u5e7f\u6cdb\u7c9f\u7c92\u72b6\u79cd\u690d\u8f6c\u79fb\u7684\u764c\u7076\uff0c\u8fd9\u662f\u5176\u5b83\u68c0\u67e5\u96be\u4ee5\u53d1\u73b0\u7684\u3002\u4e00\u65e6\u6709\u6b64\u79cd\u60c5\u51b5\uff0c\u5219\u624b\u672f\u7597\u6548\u5f88\u5dee\uff0c\u82e5\u60a3\u8005\u9ad8\u9f84\u4e14\u8eab\u4f53\u5f88\u5dee\uff0c\u5219\u53ef\u8003\u8651\u653e\u5f03\u624b\u672f\u800c\u8bd5\u7528\u5176\u5b83\u7597\u6cd5\u3002
\u4e00\u65e6\u8bca\u65ad\u4e3a\u80c3\u764c\uff0c\u8981\u53ca\u65f6\u7684\u6cbb\u7597\uff0c\u76ee\u524d\u624b\u672f\u548c\u653e\u5316\u7597\u4f5c\u4e3a\u6cbb\u7597\u80c3\u764c\u7684\u4e3b\u8981\u7597\u6cd5\uff0c\u4f46\u662f\u6548\u679c\u4e0d\u4f73\uff0c\u6700\u65b0\u7684\u751f\u7269\u6cbb\u7597\u53ef\u4ee5\u6709\u6548\u5f25\u8865\u624b\u672f\u548c\u653e\u5316\u7597\u7684\u7f3a\u9677\uff0c\u663e\u8457\u63d0\u9ad8\u80c3\u764c\u60a3\u8005\u751f\u5b58\u671f\u3002\u542c\u8bf4\u5357\u4eac\u516b\u4e00\u533b\u9662\u76ee\u524d\u91c7\u7528\u8fd9\u9879\u6280\u672f\uff0c\u5728\u5bf9\u80c3\u764c\u7684\u4e34\u5e8a\u6cbb\u7597\u4e2d\u4e5f\u53d6\u5f97\u4e86\u663e\u8457\u7597\u6548\u3002
CA125\u5bf9\u7c98\u6db2\u6027\u5375\u5de2\u764c\u7684\u8bca\u65ad\u80fd\u529b\u4e0d\u5f3a\uff0c\u5b58\u5728\u4e0a\u8ff0\u60c5\u51b5\uff1b
\u672f\u524d\u764c\u80bf\u5c3a\u5bf8\u8f83\u5927\uff0c\u800c\u4e14\u7c98\u6db2\u6027\u5375\u5de2\u764c\u5bf9\u5316\u7597\u654f\u611f\u5ea6\u4e0d\u4f73\uff0c\u7ed3\u5408\u60a3\u8005\u7684\u5e74\u9f84\u8f83\u5c0f\uff0c\u672f\u540e\u77ed\u65f6\u95f4\u5185\u590d\u53d1\u7684\u53ef\u80fd\u6027\u5f88\u5927\uff0c\u60a3\u8005\u7684\u60c5\u51b5\u5f88\u4e0d\u4e50\u89c2\u3002
2。医生建议化疗并无不妥。但个人情况不同。还要看手术时的情况。如果周围黏连严重,分界不清,那肯定要做。如果患者极度虚弱,还要看情况。总之,做肯定比不做的好处多。
绛旓細浼氱殑锛屾湁涓ょ杞Щ閫斿緞锛氳琛岃浆绉汇佽吂鑵斿唴绉嶆杞Щ銆
绛旓細璇婃柇鍗靛发鐧鏁忔劅鎬ф瘮杈冮珮锛屼絾鐗瑰紓鎬ф瘮杈冧綆锛岃繕鏈変竴浜鑳冪檶銆佽偁鐧屻佽儼鑵虹檶銆佷钩鑵虹檶銆佽偤鐧岀殑涔熶細鏈塁A125涓嶅悓绋嬪害鍗囬珮銆備复搴婃甯稿弬鑰冭寖鍥翠负琛娓呭惈閲忎綆浜35U/mL锛屽湪鑳冪檶鎮h呬腑鍙湁閮ㄥ垎鎮h匔A125鍗囬珮锛屽崌楂樼▼搴﹀父甯搁珮浜10鍊嶏紝鐢氳嚦鏇撮珮銆傚浜庢湁CA15鍗囬珮鐨勮儍鐧屾偅鑰咃紝闇瑕佽鎯曡吂鑶滅妞杞Щ銆傜粡杩囨墜鏈紝鏀惧寲鐤楃瓑娌荤枟锛...
绛旓細濮ュД浠婂勾75宀侊紝鍘诲勾鍥涙湀寮濮嬪嚭鐜拌吂鐥涳紝鍘诲尰闄㈡鏌ヤ负鑲鐧岋紝娣嬪反缁杞Щ銆傚湪鍖婚櫌鍋氫簡鏀归亾鎵嬫湳锛屽洖瀹跺悗鐥呮儏瓒婃潵瓒婇噸锛屽凡缁忛ギ椋熶笉鎬濓紝鑵圭棝鍔犲墽锛屾垜浠叏瀹剁潃鎬ヤ竾鍒嗭紝鍒板姹傚尰闂嵂銆傚湪鎴戜滑宸茬粡缁濇湜鐨勬椂鍊欙紝寰楀埌浜嗕竴浣嶅ソ蹇冧汉缁欑殑涓涓鏂癸紝鍚冧簡鍗婁釜鏈堬紝鎴戜滑鍏ㄥ鐫鎬ヤ竾鍒嗭紝鍒板姹傚尰闂嵂銆傚湪鎴戜滑宸茬粡缁濇湜鐨勬椂鍊欙紝寰楀埌...
绛旓細2銆杞Щ鎬鑵硅啘鐧岋紝濡傛灉鏉ユ簮浜庣粨鑲犵檶銆佺洿鑲犵檶鑵硅啘杞Щ鐨勶紝鐥囩姸瑕佺粨鍚堢粨鑲犵檶鍜岃吂鑶滅檶琛ㄧ幇銆傚師鏉ユ湁缁撹偁鐧屻佺洿鑲犵檶鐨勬墜鏈彶锛屾墜鏈悗鐨勫悇绉嶈偪鐦ゆ寚鏍囦細鍗囬珮锛屼細鍑虹幇鑵圭柤銆佽吂鑳銆佽吂姘达紱3銆佸鏋滄槸鑳冪檶杞Щ鍒拌吂鑶滐紝鍏剁棁鐘剁粨鍚堣儍鐧岃〃鐜帮紝姣斿涓婅吂閮ㄧ柤鐥涖佹伓蹇冦佸憰鍚愩佹秷鐦︺佽吂鑳锛岀敋鑷宠吂姘达紱4銆佸鏋滄槸鏉ユ簮浜鍗靛发鐨...
绛旓細杞Щ鎬灏忚偁鑲跨槫鐨勫彂鐥呭師鍥犲绉嶅鏍凤紝娑夊強澶氫釜鍘熷彂鐥呯伓銆傝繖浜涘師鍙戠梾鐏跺寘鎷棰堢檶銆佹伓鎬ч粦鑹茬礌鐦ゃ佸ぇ鑲犵檶銆鍗靛发鐧銆佽偩鐧屻鑳冪檶銆佽偤鐧屼互鍙婄毊鑲ょ檶绛夈傝繖浜涜偪鐦ゅ湪杞Щ杩囩▼涓紝鏈甯歌鐨勯儴浣嶆槸鍥炶偁锛屽挨鍏舵槸鏈锛岀┖鑲犱篃鏄父瑙佽浆绉诲尯鍩燂紝鐩告瘮涔嬩笅锛屽崄浜屾寚鑲犵殑杞Щ鍒欑浉瀵硅緝灏戙傝浆绉荤伓褰㈡佸悇寮傦紝鏃㈡湁鍗曚釜鍙戠敓鐨勶紝濡...
绛旓細閫氬父鎵嬫湳鍒囬櫎鑲濈檶鍚庝簩涓湀锛孉FP鍊煎簲闄嶈嚦20ng/ml浠ヤ笅锛岃嫢闄嶇殑涓嶅鎴栭檷鑰屽鍗囷紝鎻愮ず鍒囬櫎涓嶅交搴曟垨鏈夊鍙戙佽浆绉荤殑鍙兘銆傚湪杞Щ鎬鑲濈檶涓紝AFP鍊间竴鑸綆浜350-400ng/ml銆傚浜х鐨勭敓娈栬吅鑳氳儙鐧銆鍗靛发鍐呰儦绐︾檶AFP涔熶細鏄庢樉鍗囬珮銆侫FP涓害鍗囬珮涔熷父瑙佷簬閰掔簿鎬ц倽纭寲銆佹ユц倽鐐庝互鍙奌BsAg鎼哄甫鑰呫傛煇浜涙秷鍖栭亾鐧屼篃浼...
绛旓細鑳冪檶鐨勪即鐧岀患鍚堝緛鑳冪檶鍦ㄥ叾鏃╂湡銆佹櫄鏈熷強娌荤枟鍚庡鍙戞椂,寰寰鍑虹幇涓庣梾鐏舵湰韬強鍏杞Щ鐏舵棤鐩存帴鍏崇郴鐨勪竴绯诲垪涓村簥琛ㄧ幇,绉颁负浼寸檶缁煎悎寰.瀵硅儍鐧岀梾鐏惰繘琛屾墜鏈垨鍖栧銆佹斁灏勬不鐤楀悗,浼寸檶缁煎悎寰佸彲鏄庢樉 缂撹В鎴栨秷澶.杩戝勾鏉ヨ儍鐧岀殑
绛旓細鑵硅厰鍖栫枟鑽墿鐏屾敞鐨勬楠わ細1銆侀渶瑕佹槑纭吂鑵旀湁杞Щ鎬х檶鐥囷紝瀹规槗鍙戠敓鑵硅厰杞Щ鐧岀棁鐨勪富瑕佹槸鑳冪檶銆鍗靛发鐧銆佽儼鑵虹檶绛夋伓鎬ц偪鐦ゃ2銆侀渶瑕佸皢鑵硅厰閲岀殑鑵规按鍏呭垎寮曟祦锛屽寘鎷暀缃紩娴佺锛岃繘琛屽紩娴佸悗灏介噺浣胯吂鑵斿紩娴佹恫寮曟祦骞插噣銆3銆侀厤缃寲鐤楄嵂鐗╄繘琛岃吂鑵斿唴鐏屾敞锛屽绱潐閱囥侀『閾傜瓑锛岄氳繃缃鐏屽叆鍒拌吂鑵旓紝淇濈暀24灏忔椂浠ュ悗鍐嶉氳繃...
绛旓細姝讳簡浠ュ悗鍖婚櫌鍋氫簡閴村畾锛屼粬姝荤殑鏄溅绁锛岀檶缁嗚優涓鐐逛篃娌℃湁鎵╂暎锛佹槸鐧岀棁鎮h呬腑鏈楂樼殑瀵挎槦锛佹暣鏁寸檶浜27骞村晩锛佸垱閫犲嚭鐧岀棁搴峰鏈鏂扮殑甯屾湜锛佸ぉ浣垮濡堝啀娆″拰澶у璇磋蹇冮噷璇濓細鎴戝師浠ヤ负娌荤枟鐧岀棁灏辨槸鎴戠殑鐪嬪鏈锛屽彲浠ヤ竴浠d竴浠e湴娴佷紶涓嬪幓锛岀幇鍦ㄥ尰瀛﹀彂杈炬椂浠d笉鍚屽暒锛佺湡鏄暱姹熷悗娴帹鍓嶆氮锛屼竴浠f洿姣斾竴浠e己锛佸鏃...
绛旓細CA125瀵瑰嵉宸㈢殑鐗瑰紓鎬ц緝楂橈紝鏄笉鏄唬琛ㄥ嵉宸㈠泭鑲夸篃鍙兘瀵艰嚧璇ユ寚鏍囧崌楂樸傝屽鑳冪檶鐨勭洃娴嬪垯瑕侀氳繃鍏朵粬鐨勬暟鎹仈鍚堢洃娴嬶紝鍑嗙‘鐜囨洿楂樸傚鏋滆韩鎮鐧岀棁锛鍦ㄧ‘瀹氭病鏈鍗靛发鐧鐨勬儏鍐典笅锛岃繖涓寚鏍囧鐩戞祴鍏朵粬鐧岀棁鏄湁鎰忎箟鐨勶紝姣斿鍦ㄨ儍鐧屾儏鍐典笅锛岃繖涓寚鏍囪秴杩囨甯稿硷紝澶嶅彂鐨勫彲鑳芥у氨寰堝ぇ銆傚叾瀹炰笉绠′粈涔堟寚鏍囷紝鑲畾杩樻槸瑕佺粨鍚...