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教你一分钟看懂 乳腺癌病理报告单!

2016-05-18 薛卫成 好大夫在线

拿到这样一份乳腺癌病理报告,患者心里会有很多疑问。(+) (-)符号让患者一头雾水,这些指标表示什么?重点应该看哪些指标?哪些指标会影响治疗?小医生今天邀请到北京肿瘤医院的薛教授,教您一分钟看懂乳腺癌病理报告!

病理诊断的结果,一定准确吗?

乳腺癌病理报告

今天所有的话题,都围绕以上这张乳腺癌病理报告单。

这张病理报告单,上面写了个“癌”,那患者一定就得了乳腺癌吗?网上经常有报道说“这个患者被误诊了,那个患者被误诊 了”,那我会不会也有被误诊的可能呢?在这里要跟大家说明,病理诊断是癌症诊断的金标准。如果一份三甲医院的病理报告上诊断是乳腺癌,那是可信的。如果患者对病理报告有疑虑,可以申请不同医院的会诊,这是提倡的,因为不同医生看过,可能诊断得更准确。


拿到这样一份乳腺癌病理报告,患者心里会有很多疑问。(+) (-)符号让患者一头雾水,这些指标表示什么?重点应该看哪些指标?哪些指标会影响治疗?小医生今天邀请到北京肿瘤医院的薛教授,教您一分钟看懂乳腺癌病理报告!

1、边界不清、质硬不一定全是恶性肿瘤

患者拿到病理报告后,首先会看到肿瘤标本的描述中写着“多少乘以多少、边界不清、质硬”等等,但这些描述并不能明确的表示什么。肿瘤边界不清不能说明肿瘤一定是恶性的,只是恶性的概率更高一些;质硬可能是乳腺癌,也可能不是。所以患者不需要过多关注这些数值。

2、什么是浸润性导管癌1级?种类和分级是什么意思?

大家看到这张报告单上写着浸润性导管癌一级,那什么是浸润性导管癌呢?一级又代表什么意思呢?

乳腺癌有不同的类型,浸润性导管癌是最常见的一类乳腺癌,具体的乳腺癌分型患者可咨询主治医生。

乳腺癌从组织学上分为1~3级,级别越高表示乳腺癌的恶性程度越高,但是恶性程度的高低并不完全说明生存期的长短,它只是一个参考,还需要具体分析。

在同期(都是早期、中期、或者晚期)的基础上,一级的乳腺癌比三级的乳腺癌预后要好。通常一级的乳腺癌通过手术和内分泌治疗后,效果会非常好,三级的乳腺癌通过靶向治疗、化疗等也可以有不错的效果,但预后不如一级。

如果是不同分期,比如早期三级乳腺癌与晚期一级乳腺癌,这是没办法比较的,谁的生存期更长没办法预估。

3、肿瘤的大小表示什么?

病理报告上的肿瘤大小,指的是病灶浸润周围组织的面积。通常肿瘤的大小可以分为三种情况:小于2cm的肿瘤、2cm至5cm的肿 瘤、大于5cm的肿瘤,小的肿瘤比大的肿瘤情况要好。有关肿瘤的大小,患者只需要了解即可。如果患者有疑问,建议咨询主治医生,千万不要自己琢磨,上网查 来查去,网上的信息良莠不齐,患者很难甄选出正确的答案。


4、化验单上的“+”“-”都表示什么?

乳腺癌病理报告上的几个英文符号和(+)(-)号对患者更重要,它们关乎患者的治疗方式。其中最重要的是以下四个指标:

①ER表示雌激素受体,(+)表示阳性,加号越多,表示患者的雌激素受体水平越高,患者进行内分泌治疗的效果越好。
②PR表示孕激素受体,它和ER都反应患者能否进行内分泌治疗。 有些时候病理报告上显示的并不是ER(+)、PR(+),而是50%ER(++),50%表示有多少细胞表现阳性,阳性越多,进行内分泌治疗的效果越好,如果小于一定数值,则说明患者进行内分泌治疗的效果不好。
③HER2 表示人类表皮生长因子受体,如果它是阳性,患者就可以用相应的靶向药治疗。如果是阴性,患者对靶向药治疗就不敏感。目前做的免疫组化试验,结果是 HER2(3+)才表示阳性,HER2(0)、HER2(1+)表示阴性,HER-2(2+)表示不能确定是阴性还是阳性。 HER2(2+)患者需要做FISH试验进一步确定。有患者咨询,既然免疫组化试验有可能确定不了阴性阳性,是否可以直接做FISH试验呢?目前不可以, 只有当HER-2(2+)时才做FISH试验,而且即使做了FISH试验,还会出现判断不了阴性阳性的病例,所以还需要参考其他因素。
④KI67表示肿瘤增值指数,如果肿瘤长得快,那么KI67的阳性百分数就会高。如果KI67数值比较低,则说明肿瘤长得比较慢。

病理报告单上可能还会有其他数值,有的是6个指标、有的是8个指标,患者不必担心,剩余的指标可能用于跟别的疾病做鉴别诊断,可能表示目前还在探索的一些标记物,所以这些指标的阴性阳性不能明确表示什么。患者主要还是看上述四个指标。

5、三阴性乳腺癌是怎么回事?

三阴性表示三个指标是阴性的,即雌激素受体ER、孕激素受体PR、人类表皮生长因子HER2,当这三个指标都是阴性时,称为三阴性乳腺癌。

大部分三阴性乳腺癌属于不好治的,内分泌治疗和靶向治疗对患者的效果都不明显,容易出现转移,生存率不好。但也有一小部分患者情况较好,这部分患者虽然是三阴性乳腺癌,但肿瘤细胞长的比较慢。所以三阴性乳腺癌的患者应该关注KI67的指标,如果KI67大于20%,则说明恶性程度较高,如果是 10%或5%,则表示患者虽然得了三阴性乳腺癌,但是肿瘤的恶性程度比较低,增殖很慢,患者可以通过手术切除。

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    2016-09-11 1e10c84am36(暂无匿称)

    好文章,百姓也能从中学到好多医学知识

    0

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    2016-08-02 1dd8c52fm63(暂无匿称)

    非常不错!

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-24 1dedccb6m09(暂无匿称)

    说的挺好,每个专业都需要它

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-21 1dedccb6m09(暂无匿称)

    讲的真好

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-20 QQ76174b26

    讲的很清楚了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-19 milkshark

    值得学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-19 milkshark

    的确好文章

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1668600, encodeId=8a46166860029, content=<a href='/topic/show?id=d6af560460e' target=_blank style='color:#2F92EE;'>#报告单#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56046, encryptionId=d6af560460e, topicName=报告单)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435426361898, createdName=zlawrance, createdTime=Tue Jul 05 18:41:00 CST 2016, time=2016-07-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=122003, encodeId=6d7f12200390, content=好文章,百姓也能从中学到好多医学知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=158, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Sun Sep 11 08:01:00 CST 2016, time=2016-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95571, encodeId=f200955e1cb, content=非常不错!, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Tue Aug 02 22:03:00 CST 2016, time=2016-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86902, encodeId=79e686902f8, content=说的挺好,每个专业都需要它, beContent=null, objectType=article, channel=null, level=null, likeNumber=205, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Tue May 24 00:06:00 CST 2016, time=2016-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86757, encodeId=f67086e578e, content=讲的真好, beContent=null, objectType=article, channel=null, level=null, likeNumber=208, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48091727242, createdName=1dedccb6m09(暂无匿称), createdTime=Sat May 21 12:54:00 CST 2016, time=2016-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86667, encodeId=022a8666ee4, content=讲的很清楚了, beContent=null, objectType=article, channel=null, level=null, likeNumber=222, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=20751724934, createdName=QQ76174b26, createdTime=Fri May 20 09:37:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86540, encodeId=bf7f8654007, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86541, encodeId=faf086541c8, content=的确好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Thu May 19 07:37:00 CST 2016, time=2016-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=86255, encodeId=5be6862550c, content=学习一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed May 18 14:57:00 CST 2016, time=2016-05-18, status=1, ipAttribution=)]
    2016-05-18 1dd8c52fm63(暂无匿称)

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