j****u
发帖数: 1413 | 1 新闻与图片花絮请见：http://www.ustcif.org/default.php/content/1605/
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2013年5月2日，肺癌新药发明人、辉瑞公司科学家崔景荣博士（803校友）在北京为中
国
科大校友带来精彩的科普报告《癌症的发生，演变与个体化治疗》。她还介绍她作为主
导发明人的抗癌药克唑替尼 (Crizotinib) 的研发历程，并阐述了她对癌症治疗的抗药
性及抗癌的新理念的看法。
崔景荣领衔的辉瑞公司团队，因发明治疗肺癌新药“克里唑替尼”（Xalkori），2011
年
荣获美国第38届年度国家发明奖，该药2011年在美国上市，之后在北京协和医院、解放
军307医院等地进行中国临床三期实验。2013年，中国食品药品监督管理局（SFDA）批
准
该药在中国上市。
崔景荣介绍癌症的相关基础知识，癌症是细胞生长失控的表现、长期基因突变累积的结
果。她简单列举了诱发癌症的原因，并指出“癌症的复杂性在于癌细胞与周边环境的相
辅... 阅读全帖 |
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发帖数: 1 | 2 ==
The risk of cancer is increasing significantly nowadays, which is a serious
social and health problem threatening human being. Hence, numerous
scientists continuously endeavor on this imperative issue for conquering the
malignant disease and declining the cancer incidence. Due to over 60% of
currently used anticancer agents are derived from natural sources directly
or indirectly, the discovery and development of new effective and safe
cancer inhibitors from folk medicines still is important r... 阅读全帖 |
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a****y
发帖数: 1035 | 3 诸平
几十年来，不少人认为食用含有抗氧化剂的食物能够促进健康并预防癌症。而美国德克
萨斯大学西南医学研究中心（ UT Southwestern Medical Center）儿童研究所（
Children's Research Institute，CRI）的研究人员最近发现，癌细胞比正常细胞更容
易从抗氧化剂中获益,对于癌症患者，提高其膳食抗氧化剂的使用量，其效果使令人担
忧的，因为抗氧化剂会促使癌细胞扩散。无独有偶，2014年7月10日，两位美国科学家
也曾经有过类似的研究结果，发现对于抗氧化剂而言，事实可能并非像人们以前认识的
那样。他们称，抗氧化剂对癌症不但没有预防和治疗作用，甚至在某些特殊的情况下还
会增加癌症患病几率，加速肿瘤生长。相关论文发表在2014年第二期的《新英格兰医学
》（New England Journal of Medicine）杂志上——Elizabeth G. Phimister,
Navdeep S. Chandel, David A. Tuveson. The Promise and Perils of Antioxidants
for Cancer ... 阅读全帖 |
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a****y
发帖数: 1035 | 4 诸平
几十年来，不少人认为食用含有抗氧化剂的食物能够促进健康并预防癌症。而美国德克
萨斯大学西南医学研究中心（ UT Southwestern Medical Center）儿童研究所（
Children's Research Institute，CRI）的研究人员最近发现，癌细胞比正常细胞更容
易从抗氧化剂中获益,对于癌症患者，提高其膳食抗氧化剂的使用量，其效果使令人担
忧的，因为抗氧化剂会促使癌细胞扩散。无独有偶，2014年7月10日，两位美国科学家
也曾经有过类似的研究结果，发现对于抗氧化剂而言，事实可能并非像人们以前认识的
那样。他们称，抗氧化剂对癌症不但没有预防和治疗作用，甚至在某些特殊的情况下还
会增加癌症患病几率，加速肿瘤生长。相关论文发表在2014年第二期的《新英格兰医学
》（New England Journal of Medicine）杂志上——Elizabeth G. Phimister,
Navdeep S. Chandel, David A. Tuveson. The Promise and Perils of Antioxidants
for Cancer ... 阅读全帖 |
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A*******s
发帖数: 9638 | 5 昨天有同仁对我的一个case感兴趣， 我今天查了下病历， 给大家写个完整的。
53 yrs old WM, previously healthy, presented with intractable fatigue and
weight loss for 3 months. A comprehensive workup by his PCP including a CT
of chest was reported as unremarkable.
PMH: Asthma, seeing a pulmonologist who reviewed chest CT and agreed with
radiologist's report.
Soical. Smoker 1 ppd. No ETOH/Drug.
FMH: neg for CA.
ROS: Not remarkable, no diplopia, dysphagia, no fever, no joint pain, no
muscle ache.
PE: Vital normal.
No positive finding... 阅读全帖 |
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A*******s
发帖数: 9638 | 6 昨天有同仁对我的一个case感兴趣， 我今天查了下病历， 给大家写个完整的。
53 yrs old WM, previously healthy, presented with intractable fatigue and
weight loss for 3 months. A comprehensive workup by his PCP including a CT
of chest was reported as unremarkable.
PMH: Asthma, seeing a pulmonologist who reviewed chest CT and agreed with
radiologist's report.
Soical. Smoker 1 ppd. No ETOH/Drug.
FMH: neg for CA.
ROS: Not remarkable, no diplopia, dysphagia, no fever, no joint pain, no
muscle ache.
PE: Vital normal.
No positive finding... 阅读全帖 |
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d**o
发帖数: 618 | 7 I'm a little confused? Paraneoplastic neurological syndrome is autoimmune
and should not cause brain tumor by itself ah? If you find brain tumor it
should be metastasis, not paraneoplastic ah? |
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A*******s
发帖数: 9638 | 8 Early metastasis.
I meant earlier diagnosis. |
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d**o
发帖数: 618 | 9 I'm a little confused? Paraneoplastic neurological syndrome is autoimmune
and should not cause brain tumor by itself ah? If you find brain tumor it
should be metastasis, not paraneoplastic ah? |
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A*******s
发帖数: 9638 | 10 Early metastasis.
I meant earlier diagnosis. |
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I****a
发帖数: 407 | 11 1. 65 y/o white female with PMH/PSH of DM, stage 2 endometrial cancer in
1990, S/P TAH/BSO who presented with a rib fracture after bicycle accident.
Her chest x ray identified a round 2 cm nodule of right upper lobe
suggestive of primary lung cancer. She is not a smoker. Her PET CT showed
uptake of that nodule, no other abnormality. The nodule is not accessible by
CT guided biopsy so the decision was to take her to OR for lobectomy if
frozen shows lung cancer. To our surprise, the nodule is turn... 阅读全帖 |
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b******a
发帖数: 704 | 12 Here are some links about this topic. Thanks for sharing such an interesting case!
1. World J Gastroenterol. 2011 November 21; 17(43): 4747–4756.
Pancreatic metastases from renal cell carcinoma: The state of the art
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229623/
"Tumor cells apparently have a high affinity for the parenchyma of the pancreas and only there do they find the conditions they need to mature to manifest metastases. The high affinity of some renal cancer cells for the parenchyma... 阅读全帖 |
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s*******y
发帖数: 136 | 13 Rubyheart has excellent explanations and suggestions on biopsy.
Just some point from an unexperienced one (me): If the left lung (2.59 or 2
.6) is primary, usually the SUV of the primary should be higher than the
mediastiunal lymph nodes (3.5), instead of lower than the mediastinum lymph
nodes. It seems to me that there are more likelihood of some inflammatory
process, compared to malignancy process.
I saw a case two weeks ago with mediastiunal sub-cari LN SUVmax 4.7, and it
still ended up wit... 阅读全帖 |
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R*******t
发帖数: 367 | 14 I am a strong advocate for annual screening from the age 40, or earlier if
there is strong family history of family cancer. Screening MRI should also
be considered when calculated Gail score of lifetime breast cancer risk more
than 25%.
A Sweden study with 30 years trial has proven screening mammogram does save
lives, and they only used one-view screening mammogram rather than The two-
views that we use here as standard protocol.
Now there are lots of debates if we should start from 50 or do it ... 阅读全帖 |
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z****o
发帖数: 368 | 15 Thx for the case. It seems to be a solitary enhancing mass located near the
amygdala or hypothalamus. Since circadian cycle is controlled by the
hypothalamus("suprachiasmatic nucleus", according to wiki), it is likely
that the pt. is suffering from hypothalamus dysfunction due to the brain
mass. It could also compress the internal capsule or along the pathway,
causing the left side weakness.
Without further info, most possible reason for the mass is brain tumor. At
this age, it is more likel... 阅读全帖 |
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I****a
发帖数: 407 | 16 It is rare to have splenic metastasis. I suspect this is some sort of
infection with abscess formation or bleeding. |
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s*****e
发帖数: 404 | 17 Does he have known metastasis? If it is locally advanced tumor which is
unresectable, the strategy is systemic chemotherapy +/- radiology with the
goal of shrink the tumor and make it resectable. If it is metastatic disease
, the main treatment is systemic chemotherapy for palliation. If he has
very good performance status, use FOLFIRINOX; with OK performance status,
use gemicitabine based chemo regimens. If he has poor performance status,
recommend t focus on comfort care and no chemotherapy. ... 阅读全帖 |
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c*****n
发帖数: 949 | 18 在我们的center center,好像还要用PET来stage,如果不差钱让你爸爸去做个pet/CT,可
以看看有没有distant metastasis. |
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i***i
发帖数: 99 | 19 看得出eeguy你对你老婆很关心，对她的病情很了解。
我去年诊断出moderately differentiated PTC, the solid variant。WBS shows
possible metastasis in the nasal area. 现在等待第二次WBS确认是否有转移。
我丈夫在我诊断治疗期间基本上不闻不问，除了接送我去医院手术，还有就是自己
google了一下以后对我说甲状腺癌不严重所以不用担心。他从来没有问过我的病理和检
查结果，平日里依旧在各种小事上固执己见，要求我多做家务，从来没把我当成病人对
待。我的收入比他高很多，但是工作时间长，压力大，即使这样，我工作的时候还是比
回家以后看到他更开心。但是因为我们有个1岁多的孩子，我又不知道自己还能活多少
年，所以还是在忍耐，生活还是要继续。 |
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s*****e
发帖数: 404 | 20 Surgery is not indicated if she already has metastatic disease, unless she
only has a solitary metastasis which occurred late after she finished
previous treatment. |
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J*********4
发帖数: 1274 | 22
other
=====
Because the venous return of the lower 1/3 of rectal goes to Inferior vena
cava, whereas anything above will go to portal system, thus lower 1/3
metastasis to lung and the rest goes to liver.
My 2 cents |
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e******e
发帖数: 118 | 23 yes, if he has lymph nodes metastasis on path, RAI ablation 核素治疗（碘131
）should be considered. |
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yf
发帖数: 272 | 24 Your mother has stage IIIA(T3N0M0) ER positive/PR positive/HER2 positive
Invasive ductal carcinoma. There is discrepancy regarding the PR status and
Ki 67 percentage. Ki 67 is usually not so reliable. PR status is considered
positive in the second hospital pathology but negative in the first hospital
pathology. Anyway the cancer is high risk, your mother needs chemotherapy,
radiation therapy, 1 year of trastuzumab(Herceptin), and at least 5 years of
aromatase inhibitor. Every part of the treatme... 阅读全帖 |
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z******1
发帖数: 666 | 25 If there are only one or two isolated metastasis in the lung, go for
chemotherapy and surgery after chemotherapy. There is still 20-30% chance to
be cured. Do not give it up yet. |
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h*******r
发帖数: 182 | 26 来自主题: Medicalpractice版 - 求救！ AFP results:
10/6/14 10/13/14 10/20/14 11/10/14 11/17/14 12/1/14 12/8/14
2843.0 1783.7 905.5 221.5 267.1 823.9 2730.0
chest/abd/pelvic CT with contrast 12/1/14:
Impression:
1.New and enlarging liver metastasis.
2.Improving disease within the mediastinum.
3.Residual left upper lobe opacity may represent improving atelectasis.
4.Splenomegaly.
CMP: 12/8/14
AST/ALT 47/27
BUN/Cr 7/0.5
其中一个药是dexamethasone 4 MG tablet
Instructions: Take 8mg (2x4mg tablets) by m... 阅读全帖 |
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s*****e
发帖数: 404 | 27 来自主题: Medicalpractice版 - 求救！ 1. His AST/ALT is OK. If his bilirubin is normal, his liver function should
be fine, even there are liver metastasis.
2. If there has been no change of chemo regimen, given the CT finding, his
disease is resistant to the current regimen. He should switch to a different
regimen.
3. High dose chemotherapy followed by autologus stem cell transplant is a
reasonable next step. Liver transplant is not indicated in this situation.
4. Cancer center at Duke is very good. If he were my family member, I wo... 阅读全帖 |
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s*****e
发帖数: 404 | 28 来自主题: Medicalpractice版 - 甲状腺癌求助 He needs a restaging CT scan, to rule out distant metastasis first.
If he just has local recurrence in the lymph nodes, I would favor surgery
first, followed by I131, if the tumor is still I131 sensitive. Pathology
from the surgery can tell whether the characteristics of the tumor is
similar to prior tumor. |
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i*****r
发帖数: 265 | 29 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: integer (integer), 信区: MedicalCareer
标 题: 关于乳腺癌，大牛看看
发信站: BBS 未名空间站 (Wed Feb 4 02:49:02 2015, 美东)
帮个朋友问的，57岁，下面是病理报告：
Examination Findings
Specimen of right breast mass 4X2X3CM was sent for inspection. A grey nodule
with size of 2.5X2CM was found in the section. Endoscope finding: The tumor
cells were in nest shape and glandular tube. The cells arranged solidly and
grew invasively. Nuclear fission was easy to see, and nuclear atypia was
obvious. No cancer met... 阅读全帖 |
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E****e
发帖数: 315 | 30 from SeekingAlpha
The recent news announcing Genentech’s (DNA) receipt of a “Refuse to File
(RTF)” letter from the FDA for the accelerated approval of the Biologic
License Application (BLA) for trastuzumab-DM1 (T-DM1) has caused a sell-off
in Immunogen, the owner of the technology and partner on the drug with Roche
. According to the FDA letter, the refusal to give the early approval was
because “the trials had not yet exhausted all available drugs approved for
metastatic breast cancer, regardle... 阅读全帖 |
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E****e
发帖数: 315 | 31 from SeekingAlpha
The recent news announcing Genentech’s (DNA) receipt of a “Refuse to File
(RTF)” letter from the FDA for the accelerated approval of the Biologic
License Application (BLA) for trastuzumab-DM1 (T-DM1) has caused a sell-off
in Immunogen, the owner of the technology and partner on the drug with Roche
. According to the FDA letter, the refusal to give the early approval was
because “the trials had not yet exhausted all available drugs approved for
metastatic breast cancer, regardle... 阅读全帖 |
|
