Baidu
map

ALK+脑膜转移晚期肺腺癌患者诊疗带来的总结与思考

2018-12-30 李醒亚 肿瘤资讯

脑膜转移(leptomeningeal metastasis,LM)是晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)严重并发症之一,发病率低,预后差。NSCLC患者在治疗过程中约40%~55%的患者会出现脑转移,脑转移患者中约10%为脑膜转移,合并基因突变患者靶向治疗后脑/脑膜转移发生率升高。由于起病隐匿,临床表现缺乏特异性,脑膜转移早期诊断困难。因此,临床上

脑膜转移(leptomeningeal metastasis,LM)是晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)严重并发症之一,发病率低,预后差。NSCLC患者在治疗过程中约40%~55%的患者会出现脑转移,脑转移患者中约10%为脑膜转移,合并基因突变患者靶向治疗后脑/脑膜转移发生率升高。由于起病隐匿,临床表现缺乏特异性,脑膜转移早期诊断困难。因此,临床上脑膜转移患者的诊断是一难点,并且由于血脑屏障的存在,脑膜转移在治疗上也存在一定的挑战。郑州大学附属第一医院肿瘤科李醒亚教授团队为我们分享了一例在临床治疗成功典范病例,并同时提出了他们对脑膜转移患者临床诊疗的思考。

近日,郑州大学附属第一医院肿瘤科李醒亚教授团队分享了一例ALK+脑膜转移肺腺癌患者诊疗的临床常见经典病例,并对临床脑膜转移的诊断和治疗提出了自己的思考。该患者为49岁、非吸烟、女性患者,因“干咳1月”于2018年1月就诊于上海交通大学附属胸科医院,PET/CT检查提示左肺近肺门处软组织肿块影伴局部代谢活跃,大小约45mm*18mm,SUVmax7.2,双肺弥漫结节影,代谢增高,双肺转移可能性大,左侧胸腔可见少量胸腔积液;2L、4L、7组淋巴结肿大,最大淋巴结位于4L组,大小约22*16mm,SUVmax 4.9;骶骨骨质破坏伴局部代谢活跃。头颅增强MRI检查未见明显转移征象。诊断考虑左肺中央型肺癌伴单发骶骨转移可能。


图1.患者全身PET/CT影像

患者于2018年2月5日行EBUS检查,活检病理提示:4R淋巴结细胞块低分化腺癌,基因检测提示:ALK(ventana IHC)(+)、EGFR(-)、ROS1(-)。诊断考虑左肺腺癌 cT2N2M1b(双肺、单发骨) IVA期,ALK阳性。1546072407112679.png


图2.4R组淋巴结病理活检提示低分化腺癌


图3. ALK ventana IHC检测提示阳性

患者诊断IVA期伴ALK阳性,故于2018年2月开始克唑替尼治疗,治疗过程耐受性良好,疗效评价PR。并且患者于2018年9月因腰骶部疼痛行骶骨转移灶放疗。


图4.患者接受克唑替尼治疗时候的基线情况(2018-01)、以及治疗随访胸部CT影像

患者于2018年9月初开始出现间断头疼、失语、反应迟钝,并进行性加重,但头颅MRI(2018.09.10)脑实质未见明显转移,予以对症支持治疗。


图5. 2018年9月10日患者头颅MRI检查影像

患者于2018年9月27日因“剧烈头痛伴呕吐”就诊于我科——郑州大学附属第一医院肿瘤科,查体急性病容,表情痛苦,神志清楚,脑膜刺激征可疑阳性,考虑脑膜转移性可能性大,故立即行腰椎穿刺,提示颅内压400mmH2O,并行脑脊液细胞学检查 ,未见肿瘤细胞。但是结合患者症状体征仍不能排除脑膜转移可能。故行颈椎增强MRI排除其他部位脑脊液转移可能,检查结果提示颈椎增强MRI可见脑脊膜多发转移(图6)。


图6. 颈椎增强MRI提示脑脊膜多发转移影像

2018年9月29日,患者病情出现恶化,出现头痛伴短暂性意识障碍,查体双侧瞳孔等大等圆,对光反射灵敏,心率45次/分,血压160/100mmHg,考虑颅内高压导致出现Cushing反应。立即予以镇静、脱水等对症处理,并紧急腰穿行脑脊液引流,同时鞘内注射培美曲塞化疗联合全身培美曲塞单药化疗。患者于2018年9月30日恢复意识,并能交流顺畅,活动自如。同日,患者开始口服靶向阿来替尼二线治疗,并于10月2日因头痛再次腔内注射培美曲塞单药化疗。后患者肺部和中枢神经系统控制可,患者PS评分恢复0分。从治疗的结局来看,该病例算是一例非常成功的脑膜转移治疗成功的病例。


图7.治疗后复查患者颈椎核磁影像


图8. 患者治疗经过总结

总结与思考

郑州大学附属第一医院肿瘤科李醒亚教授团队在分享总结该病例的同时,他们也提出了自己的思考。首先对于肺癌脑膜转移的诊断。临床上如何进一步结合影像、临床症状体征和脑脊液细胞学检测提高脑膜转移的诊出率?对于脑脊液细胞学检测,如何检测方法检出肿瘤细胞的检出率更高?流式细胞术?CTC(循环肿瘤细胞)?对于EGFR、ALK等驱动基因阳性NSCLC如何有效监测、预防脑转移、脑膜转移的发生率?其次,在脑膜转移的治疗方面。该例患者在出现神经系统症状恶化后立即接受了脑脊液引流、鞘注化疗及全身化疗等治疗,并且神经系统症状迅速缓解,那么缓解主要得益于哪种治疗方式?在没有条件进行靶向耐药后检测的脑膜转移患者,是否应该直接采用其他其他可能有效的二代或三代ALK-TKI?针对脑膜转移,是否还有更有效的治疗方法?


李醒亚教授
主任医师,教授,博士,博士生导师
郑州大学第一附属医院肿瘤科二病区主任
中国老年学和老年医学学会精准医疗分会副主委
CSCO 理事
中国医疗保健国际交流促进会肿瘤内科分会常委
中国医药教育协会肿瘤免疫治疗专业委员会常委
河南省呼吸与危重症学会肺癌分会主委
河南省医学会肿瘤专业委员会副主委
河南省抗癌协会化疗专业委员会副主委
组建了河南省“肺癌多学科会诊” ,创建公共微信“肺癌多学科会诊”

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (16)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-04-27 tcm99hq
  2. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-22 月影子说

    学习

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-21 月影子说

    学习

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-20 月影子说

    学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-19 月影子说

    学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-18 月影子说

    学习

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-17 月影子说

    学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-15 月影子说

    学习

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1779674, encodeId=b8a11e79674cf, content=<a href='/topic/show?id=f47023119c' target=_blank style='color:#2F92EE;'>#ALK+#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2311, encryptionId=f47023119c, topicName=ALK+)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=74c2229, createdName=tcm99hq, createdTime=Sat Apr 27 06:25:00 CST 2019, time=2019-04-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1943241, encodeId=4b941943241ad, content=<a href='/topic/show?id=40875986ec9' target=_blank style='color:#2F92EE;'>#晚期肺腺癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59867, encryptionId=40875986ec9, topicName=晚期肺腺癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Mon Jan 07 13:25:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358895, encodeId=bf71358895e9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 22 10:15:15 CST 2019, time=2019-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358768, encodeId=2bf9358e681f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=121, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 21 07:48:41 CST 2019, time=2019-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358698, encodeId=aeff358698e1, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sun Jan 20 11:07:31 CST 2019, time=2019-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358597, encodeId=714535859e9f, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Sat Jan 19 08:43:50 CST 2019, time=2019-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358508, encodeId=408c358508d8, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Fri Jan 18 10:20:42 CST 2019, time=2019-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358418, encodeId=cd4c358418d2, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Thu Jan 17 09:02:51 CST 2019, time=2019-01-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358183, encodeId=326935818337, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Tue Jan 15 10:59:08 CST 2019, time=2019-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=358128, encodeId=588935812888, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2bd41982263, createdName=月影子说, createdTime=Mon Jan 14 15:09:31 CST 2019, time=2019-01-14, status=1, ipAttribution=)]
    2019-01-14 月影子说

    学习

    0

相关资讯

第二代ALK塞瑞替尼重大研究汇总

以驱动基因为目标的分子靶向治疗为晚期肺癌治疗注入了新的动力,在EGFR突变之外,间变性淋巴瘤激酶(anaplastic lymphoma kinase ,ALK)融合基因是又一个备受关注的靶点,也是临床需要特别重视的肺癌突变类型之一ALK阳性非小细胞肺癌(NSCLC)的发生率为 3%~7 %,东西方人群发生率没有显著差异。目前ALK融合基因阳性晚期NSCLC的一线治疗药物是克唑替尼,PROFI

2018年WCLC:Brigatinib为ALK阳性非小细胞肺癌患者提供更好的反应率

在第19届世界肺癌大会(WCLC)上,根据开放标签肺癌试验(ALTA-1L)的中期结果,具有ALK突变特征的非小细胞肺癌(NSCLC)患者对Brigatinib的反应优于克唑替尼。

欧盟委员会批准ALUNBRIG(brigatinib)治疗ALK+非小细胞肺癌

武田制药近日宣布,欧盟委员会已经批准ALUNBRIG(brigatinib)上市,单药治疗先前经克唑替尼治疗的成人间变性淋巴瘤激酶阳性(ALK+)的晚期非小细胞肺癌患者(NSCLC)。该决定遵循了2018年9月20日人用药品委员会(CHMP)的积极意见。

青年群体的智慧,探索ALK+一线34.8个月PFS耐药后的治疗

Young ALKademy 的设计主旨是problem based learning,即基于问题的学习模式。简单来说是通过前期个体自我探索,中期团队陈述-挑战-沟通,后期形成全体共识的,一种以学习者为中心的教学法。

2018 CSCO:ALK阳性非小细胞肺癌治疗,如何排兵布阵?

9月21日的CSCO大会上,来自上海肺科医院的周彩存教授分享了题目为“ALK阳性NSCLC治疗进展:一代、二代、三代”的报告,详细为大家讲解了近年来在ALK阳性NSCLC领域靶向治疗的演变和现状。

ALK阳性肺癌全新III期临床研究成果

欧洲肿瘤内科学会亚洲年会 (ESMO Asia 2018) 在新加坡盛大召开。主席专场(Presidential Symposium),中山大学肿瘤防治中心张力教授口头报道了亚裔ALK阳性非小细胞肺癌(NSCLC)III期ALESIA研究的主要结果。

Baidu
map
Baidu
map
Baidu
map