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盘点:近期“胰腺癌”相关研究汇总

2016-10-08 Mechront MedSci原创

据全球肿瘤流行病统计数据(GLOBOCAN)显示,世界范围内胰腺癌是排名第13位的常见肿瘤,在西方国家肿瘤相关死亡中排名第4。 小编盘点了近期与胰腺癌相关重大突破,与大家分享。 【1】胰腺癌患者出现糖尿病,可不是啥好事! 总共有1105例胰腺癌患者被纳入分析,其中257例(23%)有糖尿病,848例(77%)没有糖尿病。非糖尿病患者和糖尿病患者的未校正总生存期分别为22.3个

据全球肿瘤流行病统计数据(GLOBOCAN)显示,世界范围内胰腺癌是排名第13位的常见肿瘤,在西方国家肿瘤相关死亡中排名第4。

小编盘点了近期与胰腺癌相关重大突破,与大家分享。

【1】胰腺癌患者出现糖尿病,可不是啥好事!


总共有1105例胰腺癌患者被纳入分析,其中257例(23%)有糖尿病,848例(77%)没有糖尿病。非糖尿病患者和糖尿病患者的未校正总生存期分别为22.3个月(20.8–24.1)和18.8个月(16.9–22.1)(P=0.24)。与非糖尿病患者相比,糖尿病患者年龄较大、体重增加、更多的并发症。

调整后,多变量分析表明,胰腺癌患者如果存在糖尿病,死亡风险会增加(HR 1.19 (95% CI 1.01, 1.40), P=0.034);入院时,伴有糖尿病的胰腺癌患者,其肿瘤直径更大(33.6 vs 29.7 mm, P=0.026)。

结果表明,对于胰腺癌患者,如果存在糖尿病(相比非糖尿病的胰腺癌患者),肿瘤尺寸更大,且胰腺癌切除术和辅助化疗后的生存率降低。(文章详见——BJC:胰腺癌患者出现糖尿病,可不是啥好事!

【2】新发糖尿病?警惕胰腺癌!

研究者对60名(平均年龄67岁)胰腺癌+糖尿病成人患者,以及34名(平均年龄63岁)2型糖尿病患者(没有胰腺癌),还有30名对照(平均年龄63岁)进行了研究,比较生化标志物癌抗原(CA)19-9单独或联合microRNA-196和microRNA-200时,识别胰腺癌患者的灵敏度和特异性。

胰腺癌患者中,44名为新发糖尿病,16名有长期糖尿病。这表明,胰腺癌和新发糖尿病的关联性,比胰腺癌与长期糖尿病的关联性更强。

胰腺癌患者,CA 19-9、microRNA-196和microRNA-200,这三种标志物含量都升高(所有P < .0001)。当单独使用CA 19-9时,敏感性和特异性分别为85%和73%;三个指标一起使用时,敏感性和特异性分别为95%和77%。

作者认为,胰腺癌患者中的新发糖尿病或前驱糖尿病检测率更高,是否可以反过来,新发糖尿病作为胰腺癌的筛查之一,同时,糖尿病的出现是否会恶化病情?等等一系列问题,还需要未来进一步的研究。(文章详见——EASD 2016:新发糖尿病?警惕胰腺癌!

【3】IMM-101+GEM治疗胰腺癌

本研究评估了IMM-101(热灭活奥布分支杆菌; NCTC 13365)+吉西他滨(GEM)治疗晚期胰腺导管腺癌的有效性和安全性。

患者按2:1随机分为IMM-101 (10 mg /ml 皮内)+GEM (1000 mg /m2 静脉注射; n=75)或单独GEM(n=35)组。

结果表明,IMM-101耐受性良好;不良事件和严重不良事件发生率在两组间相似。在意向治疗人群中,IMM-101+GEM组和单独GEM组患者的中位OS分别为6.7个月和5.6个月;虽然数据上看,IMM-101+GEM组更优,但是不具有统计学意义(HR, 0.68 (95% CI, 0.44–1.04, P=0.074)。对预定义的转移亚组(84%)进行分析,IMM-101+GEM组的OS显著改善,从4.4个月到7个月(HR, 0.54, 95% CI 0.33–0.87, P=0.01)。

结果表明,与单独GEM组相比,IMM-101+GEM是安全和耐受的,并且对转移性疾病患者的生存有益。在未来还需要进一步的研究来验证这一发现。(文章详见——BJC:IMM-101+GEM治疗胰腺癌

【4】放疗治疗睾丸癌,会增加胰腺癌风险


研究纳入了80例5年TC幸存者,评估了放疗时胰腺暴露剂量,匹配145例对照组。

诊断TC三十年后,总的第二原发性胰腺癌的累积发病率为1.1%。放疗与风险增加2.9倍有关(患者组 72 (90%)例,对照组 115 (80%)例)。胰腺放疗剂量暴露每增加1Gy,胰腺癌风险呈线性增加为0.12(P-trend<0.001);25 Gy vs <25 Gy,胰腺癌风险更大,OR=4.6 (95% CI 1.9–11.0)。TC诊断后≥20年,放射线相关胰腺癌风险仍升高(P=0.020)。此外,胰腺癌风险与烷化剂或铂类药物化疗周期数有关,化疗周期数增加,胰腺癌风险增加(P=0.057)。

结果表明,胰腺暴露射线剂量与随后胰腺癌风险之间存在剂量-反应关系,超过20年的时间里,风险都存在。化疗对胰腺癌风险的影响,还需要未来进一步的研究。(文章详见——BJC:放疗治疗睾丸癌,会增加胰腺癌风险

【5】西他列汀,是否会增加胰腺炎和胰腺癌风险?

TECOS试验中,纳入了14671例参与者,中位随访3年。随机接受西他列汀的参与者中,23(0.3%)名患者发生胰腺炎(安慰剂组为12[0.2%]名;HR 1.93 [95% CI 0.96–3.88], P = 0.065; 0.107 vs. 0.056/100人年),合计发生25例和27例事件。西他列汀组有4名患者出现了重症胰腺炎(2例致命性)。西他列汀组和安慰剂组分别有9 [0.1%]名和14 [0.2%]名患者发生胰腺癌(HR 0.66 [95% CI 0.28–1.51], P = 0.32; 0.042 vs. 0.066/100人年)。

合并其他两个DPP-4I心血管结局的研究进行荟萃分析,研究者发现,DPP-4I会增加患者的急性胰腺炎风险(RR 1.78 [95% CI 1.13–2.81], P = 0.01);但不会增加胰腺癌风险(RR 0.54 [95% CI 0.28–1.04], P = 0.07)。

结果表明,使用西他列汀进行治疗时,胰腺炎和胰腺癌都是罕见的事件,并且与安慰剂组相比,西他列汀组患者胰腺炎发生率更高、胰腺癌发生率更低,但是这些发生率均无统计学显著差异。不过荟萃分析结果显示,DPP-4I治疗会胰腺炎的绝对风险小幅度增加。(文章详见——Diabetes Care:西他列汀,是否会增加胰腺炎和胰腺癌风险?

【6】补充维生素A为胰腺癌治疗带来希望


来自英国的科学家们发现维生素A可以在实验室的细胞模型上帮助对抗这种常见的胰腺癌。

在健康的胰腺中星形细胞以休眠方式存在,储存了许多维生素A。但是在PDAC发生以后,这些星形细胞就会发生激活应答来自肿瘤的信号,失去储存的维生素A。激活的星形细胞会在肿瘤周围形成致密结缔组织,癌细胞在这种组织的帮助下扩散到身体其他部分,该组织还会阻碍抗癌药物进入肿瘤。

在这项新研究中,研究人员观察到通过维生素A参与的一个过程或可帮助关闭激活的胰腺星形细胞,阻止肿瘤周围结缔组织形成。

在健康机体中维生素A可以变成全反式维甲酸,发挥调节正常生长和发育等多种功能。当研究人员在实验室的细胞上诱导这一过程,发现全反式维甲酸可以关闭星形细胞用来重塑环境的应力,这会减少纤维化的产生,也会形成一种让胰腺肿瘤的扩散变得更加困难的环境。(文章详见——Nat Com:补充维生素A为胰腺癌治疗带来希望

【7】胰腺癌患者可考虑Folfirinox化疗方案


研究者对所有在新辅助治疗后进行手术的PDAC患者进行了分析(临床病理特征、二次切除率、结局)。患者接受Folfirinox化疗方案或其他治疗方案。2001年12月-2015年6月,575名患者进行了新辅助治疗,对胰腺癌再分期后进行手术切除治疗。其中292(50.8%)名患者达到成功切除肿瘤。
 
不同治疗方案的患者切除率分别为:Folfirinox化疗方案 61% (76/125)、吉西他滨+放疗 46% (150/322)、其他治疗方案 52% (66/128)。Folfirinox化疗方案与吉西他滨+放疗和其他治疗方案相比,切除率方面的P值为0.026。
 
切除和非切除相比,患者的平均总生存期分别为15.3个月和8.5个月(P < 0.0001)。Folfirinox化疗方案、吉西他滨和其他治疗方案组患者的中位生存期分别为16个月、16.5个月和14.5个月;三年生存率分别为28.1%、23.2%和19.7%(P = 0.8582)。
 
多变量分析显示,Folfirinox与良好预后有独立相关性。
 
结果表明,对于PDAC患者,Folfirinox是胰腺癌新辅助治疗中一个有价值的治疗选择。就目前的数据,这是迄今最大研究人群的试验,Folfirinox相比其他治疗方案,有更高的二次切除率和更好的总生存期。(文章详见——Annals of Surgery:胰腺癌患者可考虑Folfirinox化疗方案

【8】二甲双胍联合纳米药物是治疗胰腺癌的好选择

研究人员首先从一种叫做BPTES的试验性药物开始,在此之前BPTES已经在多种癌症动物模型中得到检测,都不能帮助减小肿瘤尺寸。

研究人员选择将BPTES包装到一种由聚乙二醇包被的纳米颗粒胶囊中;这种纳米颗粒能够帮助药物穿过靠近癌细胞的毛细血管,使药物在肿瘤组织中的停留时间更长。他们将这种纳米颗粒药物注射到移植了人类胰腺肿瘤的小鼠模型体内。

经过观察发现一段时间之后接受了纳米颗粒药物治疗的小鼠肿瘤缩小一半,而没有使用纳米运输系统的药物没有改变肿瘤大小。随后研究人员在缩小之后的肿瘤中继续寻找促进肿瘤生长的主要代谢途径,他们给小鼠模型注射了带标记的谷氨酰胺和葡萄糖,随后追踪这些物质在小鼠体内的分解,发现肿瘤细胞中含有大量的乳酸,这是葡萄糖代谢途径的一种终产物。

研究人员将抗糖尿病药物二甲双胍与胶囊化的BPTES联合使用,用以治疗移植了人类胰腺肿瘤的小鼠,结果表明药物组合使肿瘤缩小了至少50%,效果好于单种药物治疗。(文章详见——PNAS:二甲双胍联合纳米药物是治疗胰腺癌的好选择

【9】二甲双胍还可以治疗胰腺癌?

研究纳入了1916名PDAC患者,在诊断腺癌前存在DM,且使用降糖药1年以上。其中1098例(57.3%)使用二甲双胍治疗,818例(42.7%)使用其他降糖药治疗。

二甲双胍与非二甲双胍组相比,平均生存分别为5.5个月和4.2个月(P<0.01)。校正包括DCSI评分、Charlson评分、慢性肾脏疾病(CKD)等混杂因素后,二甲双胍组的患者与其他患者相比,死亡风险下降12%(HR=0.88, 95%CI: 0.81-0.96, P<0.01)。分层分析显示,不管DCSI评分、Charlson评分、CKD或是否使用胰岛素/其他降糖药物,以上差异仍存在(所有P<0.01)。

结果表明,使用二甲双胍治疗的糖尿病患者,相比其他降糖药治疗的患者而言,诊断PDAC后其生存有改善。这些结果提示二甲双胍或许可以作为糖尿病+PDAC患者的辅助治疗。(文章详见——Am J Gastroenterol:二甲双胍还可以治疗胰腺癌?

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1800388, encodeId=3ce818003887a, content=<a href='/topic/show?id=cbf9e254051' target=_blank style='color:#2F92EE;'>#相关研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72540, encryptionId=cbf9e254051, topicName=相关研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon Apr 10 23:47:00 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149502, encodeId=c43414950235, content=文章翔实,为预防,治疗和诊断胰腺癌提供了宝贵的数据资料,认真学习了。疯狂点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 18 15:56:03 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145900, encodeId=497f14590079, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue Oct 11 22:22:51 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145287, encodeId=5cfb14528e84, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, 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=Tue Oct 11 20:12:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143155, encodeId=581a14315512, content=很好的总结, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=57ab1959292, createdName=boc_111, createdTime=Mon Oct 10 12:49:42 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143055, encodeId=b933143055f4, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, 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=Mon Oct 10 10:52:09 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142299, encodeId=95af14229904, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:08 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142298, encodeId=47c014229863, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:02 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2016-10-18 ylzr123

    文章翔实,为预防,治疗和诊断胰腺癌提供了宝贵的数据资料,认真学习了。疯狂点赞!

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1800388, encodeId=3ce818003887a, content=<a href='/topic/show?id=cbf9e254051' target=_blank style='color:#2F92EE;'>#相关研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72540, encryptionId=cbf9e254051, topicName=相关研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon Apr 10 23:47:00 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149502, encodeId=c43414950235, content=文章翔实,为预防,治疗和诊断胰腺癌提供了宝贵的数据资料,认真学习了。疯狂点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 18 15:56:03 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145900, encodeId=497f14590079, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue Oct 11 22:22:51 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145287, encodeId=5cfb14528e84, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, 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=Tue Oct 11 20:12:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143155, encodeId=581a14315512, content=很好的总结, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=57ab1959292, createdName=boc_111, createdTime=Mon Oct 10 12:49:42 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143055, encodeId=b933143055f4, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, 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=Mon Oct 10 10:52:09 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142299, encodeId=95af14229904, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:08 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142298, encodeId=47c014229863, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:02 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1800388, encodeId=3ce818003887a, content=<a href='/topic/show?id=cbf9e254051' target=_blank style='color:#2F92EE;'>#相关研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72540, encryptionId=cbf9e254051, topicName=相关研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon Apr 10 23:47:00 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149502, encodeId=c43414950235, content=文章翔实,为预防,治疗和诊断胰腺癌提供了宝贵的数据资料,认真学习了。疯狂点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 18 15:56:03 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145900, encodeId=497f14590079, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue Oct 11 22:22:51 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145287, encodeId=5cfb14528e84, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, 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=Tue Oct 11 20:12:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143155, encodeId=581a14315512, content=很好的总结, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=57ab1959292, createdName=boc_111, createdTime=Mon Oct 10 12:49:42 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143055, encodeId=b933143055f4, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, 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=Mon Oct 10 10:52:09 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142299, encodeId=95af14229904, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:08 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142298, encodeId=47c014229863, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:02 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2016-10-11 1e10c84am36(暂无匿称)

    好文章,受益

    0

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    2016-10-10 boc_111

    很好的总结

    0

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    2016-10-10 1e10c84am36(暂无匿称)

    文章很好,继续关注

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1800388, encodeId=3ce818003887a, content=<a href='/topic/show?id=cbf9e254051' target=_blank style='color:#2F92EE;'>#相关研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72540, encryptionId=cbf9e254051, topicName=相关研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon Apr 10 23:47:00 CST 2017, time=2017-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=149502, encodeId=c43414950235, content=文章翔实,为预防,治疗和诊断胰腺癌提供了宝贵的数据资料,认真学习了。疯狂点赞!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Oct 18 15:56:03 CST 2016, time=2016-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145900, encodeId=497f14590079, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, 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=Tue Oct 11 22:22:51 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=145287, encodeId=5cfb14528e84, content=好文章,受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, 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=Tue Oct 11 20:12:21 CST 2016, time=2016-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143155, encodeId=581a14315512, content=很好的总结, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=57ab1959292, createdName=boc_111, createdTime=Mon Oct 10 12:49:42 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=143055, encodeId=b933143055f4, content=文章很好,继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, 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=Mon Oct 10 10:52:09 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142299, encodeId=95af14229904, content=继续关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:08 CST 2016, time=2016-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=142298, encodeId=47c014229863, content=谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Sun Oct 09 00:30:02 CST 2016, time=2016-10-09, status=1, ipAttribution=)]
    2016-10-09 知难而进

    继续关注!

    0

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    2016-10-09 知难而进

    谢谢分享!

    0

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