{"id":3534,"date":"2023-03-13T08:28:46","date_gmt":"2023-03-13T00:28:46","guid":{"rendered":"https:\/\/tnetpca.com\/?p=3534"},"modified":"2025-08-31T13:35:01","modified_gmt":"2025-08-31T05:35:01","slug":"%e4%bb%80%e9%ba%bc%e6%98%af%e7%a5%9e%e7%b6%93%e5%85%a7%e5%88%86%e6%b3%8c%e7%98%a4%e7%9a%84%e5%85%a8%e8%ba%ab%e6%80%a7%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/tnetpca.com\/?p=3534","title":{"rendered":"\u4ec0\u9ebc\u662f\u795e\u7d93\u5167\u5206\u6ccc\u7624\u7684\u5168\u8eab\u6027\u6cbb\u7642?"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text]\u300c\u91ab\u5e2b\uff0c\u70ba\u4f55\u6211\u9700\u8981\u505a\u6a19\u9776\u6cbb\u7642\uff0c\u6211\u7684\u670b\u53cb\u537b\u4e0d\u7528?\u300d\u5e74\u8f15\u7684\u809d\u8f49\u79fb\u80f0\u81df\u795e\u7d93\u5167\u5206\u6ccc\u7624\u674e\u5927\u96c4\u7126\u6025\u5730\u554f\u3002<\/span><\/p>\n

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 <\/p>\n

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\u91dd\u5c0d\u4efb\u4f55\u816b\u7624\u7684\u6cbb\u7642\uff0c\u76ee\u524d\u5e7e\u4e4e\u90fd\u4e0d\u6703\u812b\u96e2\u5169\u5927\u5206\u985e: \u5c40\u90e8\u6cbb\u7642\u6216\u662f\u5168\u8eab\u6cbb\u7642\uff0c\u7576\u7136\u4e5f\u6709\u5169\u7a2e\u5408\u4f75\u7684\u6cbb\u7642\u7b56\u7565\u3002\u5176\u4e2d\uff0c\u5c40\u90e8\u6cbb\u7642\u6307\u7684\u662f\u4efb\u4f55\u4ee5\u5feb\u901f\u79fb\u9664\u816b\u7624\u5927\u5c0f\u70ba\u76ee\u7684\u7684\u65b9\u6cd5\uff0c\u4f8b\u5982: \u539f\u767c\u816b\u7624\u6216\u91dd\u5c0d\u8f49\u79fb\u75c5\u7076\u7684\u624b\u8853\u3001\u653e\u5c04\u6cbb\u7642\u3001\u809d\u8f49\u79fb\u6813\u585e\u6cbb\u7642 \u3001\u809d\u8f49\u79fb\u653e\u5c04\u6813\u585e\u6cbb\u7642(\u4f8b\u5982\u91d490)\u3001\u809d\u8f49\u79fb\u5c04\u983b\u6cbb\u7642(\u4fd7\u7a31\u96fb\u71d2\uff0cradiofrequency, RFA)\u751a\u81f3\u9084\u6709\u51b7\u51cd\u7642\u6cd5 (cryotherapy)\u7b49\u7b49\u3002\u800c\u5168\u8eab\u6027\u6cbb\u7642\u7684\u6642\u6a5f\uff0c\u7c21\u55ae\u8aaa\u5c31\u662f\u7121\u6cd5\u4f7f\u7528\u524d\u8ff0\u5c40\u90e8\u6cbb\u7642\u4f86\u75ca\u7652\u795e\u7d93\u5167\u5206\u6ccc\u7624\u7684\u6642\u5019\uff08\u4f8b\u5982\u6709\u8f49\u79fb\u75c5\u7076\u3001\u958b\u5200\u7121\u6cd5\u75ca\u7652\u3001\u7121\u6cd5\u958b\u4e7e\u6de8\u3001\u7121\u6cd5\u8010\u53d7\u958b\u5200\u7b49\u7b49\uff09\u5c31\u8981\u4f7f\u7528\u3002\u5c24\u5176\uff0c\u795e\u7d93\u5167\u5206\u6ccc\u816b\u7624\u7279\u5225\u559c\u6b61\u5b89\u5b89\u975c\u975c\u5730\u5728\u4e00\u958b\u59cb\u8a3a\u65b7\u7684\u6642\u5019\u5c31\u5df2\u7d93\u8f49\u79fb\u5230\u809d\u81df\uff08\u6839\u64da\u7814\u7a76\u7d71\u8a08\u670920-90%\u90fd\u6703\u8f49\u79fb\u5230\u809d\u81df\uff09\uff0c\u6b64\u6642\uff0c\u7e31\u4f7f\u81e8\u5e8a\u4e0a\u7121\u75c7\u72c0\uff0c\u7e31\u4f7f\u53ef\u4ee5\u7528\u958b\u5200\u53bb\u9664\u90e8\u5206\u816b\u7624\uff08\u4e26\u975e\u5168\u90e8\u7684\u816b\u7624\uff09\uff0c\u5168\u8eab\u6027\u6cbb\u7642\uff08\u5305\u542b\u8cc0\u723e\u8499\u6cbb\u7642\u3001\u6a19\u9776\u6cbb\u7642\u3001\u514d\u75ab\u6cbb\u7642\u3001\u5316\u5b78\u6cbb\u7642\u3001\u7d30\u80de\u6cbb\u7642\u3001\u6838\u7d20\u6cbb\u7642\u5982PRRT\u7b49\uff09\u4ecd\u7136\u662f\u5fc5\u9808\u7684!<\/span><\/p>\n

 <\/p>\n

\u5168\u8eab\u6cbb\u7642\u4e4b\u4e00\uff1a\u6a19\u9776\u6cbb\u7642<\/strong><\/span><\/p>\n

\u76ee\u524d\u5728\u795e\u7d93\u5167\u5206\u6ccc\u816b\u7624\u7684\u9818\u57df\u4e2d\uff0c\u4ecd\u7136\u6709\u975e\u5e38\u591a\u7684\u65b0\u6a19\u9776\u85e5\u7269\u6b63\u5728\u9032\u884c\u81e8\u5e8a\u8a66\u9a57\u3002\u5176\u4e2d\uff0c\u5df2\u7d93\u901a\u904e\u7b2c\u4e09\u671f\u81e8\u5e8a\u8a66\u9a57\u8b49\u5be6\u5c0d\u60a3\u8005\u6709\u5e6b\u5fd9\uff08\u5ef6\u9577\u60e1\u5316\u7684\u6642\u9593\uff09\u7684\u6709sunitinib\u8207everolimus\u5169\u7a2e\u53e3\u670d\u85e5\u7269\u3002\u9019\u4e5f\u662f\u53f0\u7063\u653f\u5e9c\u6839\u64da\u81e8\u5e8a\u8a66\u9a57\u7684\u7d50\u679c\u7d66\u4e88\u6709\u689d\u4ef6\u5065\u4fdd\u7d66\u4ed8\u7684\u85e5\u7269\u3002\u82e5\u5c0d\u85e5\u7269\u7d66\u4ed8\u6709\u7591\u616e\uff0c\u53ef\u4ee5\u8ddf\u816b\u7624\u79d1\u91ab\u5e2b\u9032\u884c\u8a0e\u8ad6\uff0c\u4e0d\u7528\u64d4\u5fc3\u91ab\u5e2b\u4e0d\u8ddf\u4f60\u89e3\u91cb\u7684\u3002\u53e3\u670d\u85e5\u7269\u7684\u6cbb\u7642\u6a5f\u5236\u8207\u53ef\u80fd\u526f\u4f5c\u7528\uff0c\u6211\u5011\u6703\u5728\u53e6\u5916\u4e00\u7bc7\u6587\u7ae0\u4e2d\u8a73\u8ff0\u3002<\/span><\/p>\n

 <\/p>\n

\u5168\u8eab\u6cbb\u7642\u4e4b\u4e8c\uff1a\u5316\u5b78\u6cbb\u7642\uff08\u4fd7\u7a31\u5316\u7642\uff09<\/strong><\/span><\/p>\n

\u300c\u91ab\u5e2b\uff0c\u5316\u7642\u807d\u8d77\u4f86\u5c31\u5f88\u53ef\u6015\uff0c\u6211\u4e0d\u8981\uff01\u300d\u5927\u96c4\u5f88\u5feb\u5730\u53cd\u6620\u4e86\u4ed6\u7684\u5bb3\u6015\u3002<\/span><\/p>\n

\u300c\u5316\u7642\u96d6\u7136\u78ba\u5be6\u662f\u7528\u85e5\u7269\u6bba\u6389\u7d30\u80de\u7684\u65b9\u5f0f\uff0c\u597d\u7684\u58de\u7684\u7d30\u80de\u90fd\u6703\u6b7b\u6389\uff0c\u4f46\u91dd\u5c0d\u67d0\u4e9b\u764c\u7d30\u80de\uff08\u4f8b\u5982G2\u6216 G3\uff09\uff0c\u5316\u7642\u53ef\u80fd\u6709\u6642\u5019\u6bd4\u8f03\u5feb\u8b93\u816b\u7624\u63a7\u5236\u4e0b\u4f86\u3002\u4f46\u6211\u77e5\u9053\u4f60\u4e00\u5b9a\u9084\u5728\u5bb3\u6015\u526f\u4f5c\u7528\u3002\u300d<\/span><\/p>\n

\u300c\u5c0d\uff0c\u5176\u5be6\u6211\u4e5f\u5e0c\u671b\u816b\u7624\u5feb\u9ede\u7e2e\u5c0f\uff0c\u4f46\u5c31\u662f\u5bb3\u6015\u6389\u982d\u9aee\u3001\u5641\u5fc3\u5614\u5410\u90a3\u4e9b\u5bb6\u88e1\u8001\u4eba\u8aaa\u7684\u526f\u4f5c\u7528\u3002\u300d\u5927\u96c4\u7e7c\u7e8c\u8ffd\u554f\u3002<\/span><\/p>\n

\u5316\u7642\u7684\u526f\u4f5c\u7528\u554a\uff0c\u6bcf\u500b\u5316\u7642\u8655\u65b9\u90fd\u4e0d\u4e00\u6a23\uff0c\u4f8b\u5982\u6cbb\u7642\u80ba\u764c\u7684\u8ddf\u6cbb\u7642\u4e73\u764c\u7684\u5c31\u4e0d\u4e00\u6a23\u3002\u53cd\u800c\u5728\u795e\u7d93\u5167\u5206\u6ccc\u7624\u6703\u7528\u5230\u7684\u85e5\u7269(\u4f8b\u5982temozolamide(TMZ, \u5e1d\u76df\u591a\u00ae), capecitbaine(Xeloda, \u622a\u7624\u9054\u00ae), dacarbazine, 5-FU, irinotecan, cisplatin, etoposide, topotecan\u7b49\u7b49)\u9084\u7b97\u4e0d\u592a\u6703\u6389\u982d\u9aee\uff0c\u5641\u5fc3\u3001\u5614\u5410\u7684\u526f\u4f5c\u7528\u4e5f\u6709\u4e86\u5f88\u65b0\u7684\u9810\u9632\u5614\u5410\u7528\u85e5\uff0c\u96d6\u7136\u4e0d\u8212\u670d\u4f86\u81ea\u65bc\u597d\u7684\u7d30\u80de\u4e5f\u53d7\u50b7\u4e86\uff0c\u4f46\u58de\u7684\u7d30\u80de\u901a\u5e38\u6703\u6b7b\u5f97\u66f4\u5feb\uff0c\u5982\u679c\u7d66\u4e88\u9069\u7576\u7684\u7167\u8b77\u8207\u71df\u990a\u88dc\u7d66\uff0c\u597d\u7684\u7d30\u80de\u901a\u5e38\u6703\u9806\u5229\u6062\u5fa9\u7684\u3002\u5c0d\u65bc\u526f\u4f5c\u7528\u7684\u7167\u8b77\uff0c\u4e0d\u540c\u7684\u91ab\u5e2b\u6703\u6709\u4e0d\u540c\u7684\u6280\u5de7\uff0c\u4f46\u73fe\u4eca\u53f0\u7063\u7684\u91ab\u7642\u77e5\u8b58\u5f88\u9032\u6b65\uff0c\u91ab\u9662\u8207\u91ab\u9662\u4e4b\u9593\u3001\u91ab\u5e2b\u8207\u91ab\u5e2b\u4e4b\u9593\u4e26\u6c92\u6709\u592a\u5927\u5dee\u7570\uff0c\u4e0d\u9808\u592a\u904e\u64d4\u5fc3\u91ab\u5e2b\u7684\u6280\u8853\u3002<\/span><\/p>\n

 <\/p>\n

\u5168\u8eab\u6cbb\u7642\u4e4b\u4e09\uff1a\u8cc0\u723e\u8499\u6cbb\u7642<\/strong><\/span><\/p>\n

\u300c\u91ab\u5e2b\uff0c\u70ba\u4f55\u6709\u7684\u4eba\u6703\u53ea\u7d66\u4e88\u8cc0\u723e\u8499\u6cbb\u7642\uff0c\u9019\u4e0d\u662f\u4e73\u764c\u624d\u7d66\u7684\u55ce\uff1f\u300d\u5927\u96c4\u7a81\u7136\u554f\u8d77\u4e4b\u524d\u6211\u5011\u78ba\u5be6\u66fe\u7d93\u6709\u4e09\u5e74\u591a\u53ea\u4f7f\u7528\u4e86\u8cc0\u723e\u8499\u6cbb\u7642\uff0c\u4f46\u600e\u9ebc\u4eca\u5929\u624d\u60f3\u8d77\u4f86\u8981\u554f\u6211\u5462\uff1f\u6211\u5fc3\u88e1\u7591\u60d1\u8457\uff0c\u539f\u4f86\u5927\u96c4\u9084\u662f\u4e0d\u592a\u61c2\u81ea\u5df1\u7684\u75be\u75c5\u8ddf\u6cbb\u7642\u554a\u3002<\/span><\/p>\n

\u8cc0\u723e\u8499\u6cbb\u7642\uff0c\u9867\u540d\u601d\u7fa9\uff0c\u5c31\u662f\u900f\u904e\u58d3\u6291\u816b\u7624\u76f8\u95dc\u7684\u8cc0\u723e\u8499\u4f86\u58d3\u6291\u816b\u7624\u7684\u751f\u9577\u3002\u78ba\u5be6\uff0c\u4e73\u764c\u8207\u524d\u5217\u817a\u764c\u662f\u6700\u5178\u578b\u7684\u8cc0\u723e\u8499\u764c\u75c7\uff0c\u4f46\u5225\u5fd8\u8a18\u4e86\u795e\u7d93\u5167\u5206\u6ccc\u816b\u7624\u624d\u662f\u8cc0\u723e\u8499\u6cbb\u7642\u7684\u9f3b\u7956\uff01\u56e0\u70ba\u795e\u7d93\u5167\u5206\u6ccc\u816b\u7624\u6709\u9ad8\u905480%-100%\u7684\u6a5f\u7387\u6703\u6709 SSTR\u8868\u9762\u6297\u539f\u7684\u8868\u73fe\uff0c\u53ef\u4ee5\u5206\u6ccc\u5167\u5206\u6ccc\u7269\u8cea(\u4f8b\u5982CgA, NSE , VIP, gastrin \u7b49\u7b49)\u9020\u6210\u816b\u7624\u7684\u75c7\u72c0\uff0c\u56e0\u6b64\u6709\u78ba\u5b9a\u58d3\u6291\u7684\u8cc0\u723e\u8499\u6e90\u982d\uff0c\u6240\u4ee5\u58d3\u6291\u795e\u7d93\u5167\u5206\u6ccc\u8cc0\u723e\u8499\u7684\u6cbb\u7642\u5c31\u8b8a\u6210\u4e00\u7a2e\u975e\u5e38\u5408\u7406\u7684\u6cbb\u7642\uff0c\u5728\u53f0\u7063\uff0c\u81f3\u5c11\u6709\u5169\u7a2e\u85e5\u7269(octreotide, lanreotide)\u662f\u6709\u689d\u4ef6\u7684\u5065\u4fdd\u7d66\u4ed8\u3002<\/span><\/p>\n

 <\/p>\n

\u5168\u8eab\u6cbb\u7642\u4e4b\u56db\uff1a\u6838\u7d20\u6cbb\u7642<\/strong>(PRRT)<\/strong><\/span><\/p>\n

\u6838\u7d20\u6cbb\u7642\uff0c\u9867\u540d\u601d\u7fa9\u5c31\u662f\u5229\u7528\u8f3b\u5c04\u7dda\u7269\u8cea\u4f86\u6cbb\u7642\u764c\u75c7\uff0c\u5176\u5be6\u4e26\u975e\u65b0\u7684\u6cbb\u7642\u9078\u9805\uff0c\u53ea\u662f\u5728\u6b50\u6d32\u9032\u884c\u591a\u5e74\u5f8c\uff0c\u5728\u53f0\u7063\u597d\u4e0d\u5bb9\u6613\u5728\u53f0\u7063\u795e\u7d93\u5167\u5206\u6ccc\u7624\u5b78\u6703\u3001\u60a3\u8005\u5354\u52a9\u5718\u9ad4\u3001\u91ab\u9662\u6838\u5b50\u91ab\u5b78\u79d1\u5c08\u5bb6\u8207\u570b\u969b\u85e5\u5ee0\u7684\u52aa\u529b\u4e0b\u624d\u5f15\u9032\u53f0\u7063\u3002\u5c0d\u65bc\u9069\u5408\u7684\u65cf\u7fa4\uff0c\u806f\u5408\u8cc0\u723e\u8499\u6cbb\u7642\uff0c\u6cbb\u7642\u6548\u679c\u5927\u7d04\u53ef\u905440%\u53ef\u5f97\u5230\u816b\u7624\u7de9\u89e3\uff0c\u5c0d\u5b58\u6d3b\u6642\u9593\u4e5f\u6709\u5e6b\u52a9\uff0c\u4f46\u4ecd\u7136\u6709\u6cbb\u7642\u9650\u5236\uff0c\u56e0\u6b64\u4e26\u975e\u795e\u85e5\u3002\u4f8b\u5982Krenning\u2019s score(\u9700\u9032\u884cGrallium scans)\u9700\u8981\u7b26\u5408G1\/G2\u7684\u5206\u985e\uff0c\u5426\u5247\u6548\u679c\u7121\u6cd5\u9054\u5230\uff0c\u4e0d\u50c5\u50b7\u8377\u5305\u5c0d\u816b\u7624\u4e5f\u4e0d\u4e00\u5b9a\u6709\u6548\u3002\u5c0d\u65bc\u9019\u6a23\u7684\u500b\u6848\uff0c\u816b\u7624\u79d1\u91ab\u5e2b\u6703\u4e3b\u8cac\u62db\u958b\u591a\u5c08\u79d1\u5718\u968a\u6703\u8b70\uff0c\u8207\u6838\u5b50\u91ab\u5b78\u79d1\u91ab\u5e2b\u8a0e\u8ad6\uff0c\u8a55\u4f30\u9032\u884c\u7684\u512a\u7f3a\u9ede\u518d\u9032\u884c\u6cbb\u7642\u7684\u5b89\u6392\uff0c\u671f\u5f85\u80fd\u5e36\u7d66\u60a3\u8005\u6700\u5927\u7684\u597d\u8655\u3002<\/span><\/p>\n

\u300c\u91ab\u5e2b\uff0c\u60a8\u8b1b\u4e86\u9019\u9ebc\u591a\uff0c\u6211\u5927\u6982\u77e5\u9053\u6211\u53ef\u4ee5\u63a5\u53d7\u6cbb\u7642\u7684\u65b9\u5411\u4e86\u3002\u300d\u5927\u96c4\u7d42\u65bc\u9732\u51fa\u7406\u89e3\u7684\u7b11\u5bb9\uff0c\u672a\u4f86\u7684\u8def\uff0c\u6211\u5011\u6703\u966a\u5927\u96c4\u4e00\u8d77\u5ea6\u904e\u3001\u4e00\u8d77\u596e\u6230\u7684!<\/span><\/p>\n

 <\/p>\n

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