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AJOG:晚期子宫内膜癌是否有必要进行肿瘤细胞减灭术?

2021-05-18 Nebula MedSci原创

大部分晚期子宫内膜癌患者在肿瘤细胞减灭术后的残留肿瘤病灶较小(肉眼不可见或<1cm),与相对较好的无进展生存期和总生存期相关

子宫内膜癌是女性第四常见的癌症。子宫内膜癌早期即可出现异常的阴道出血/排液,约80-90%的病例在早期确诊。少见子宫内膜癌患者确诊时已是晚期,因此,目前缺乏可指导晚期子宫内膜癌的诊疗的前瞻性证据。

本研究旨在总结肿瘤细胞减灭术(PCS)治疗晚期子宫内膜癌的效果

Albright等人采用检索词“子宫内膜癌”、“晚期”和“肿瘤细胞减灭术”检索了MEDLINE、Embase和Scopus数据库从创建到2020年9月11日期间包含≥10例接受PCS治疗的晚期子宫内膜癌患者、并有根据PCS后残留肿瘤程度报告发病率和生存结果的全英文文献。两个审稿人独立筛选研究,并由第三个审稿人审核。

筛查了1219项研究,最终纳入了其中34项研究,包含单中心和多中心研究、跨越6-24年、各种病理类型(子宫内膜样/浆液性/透明细胞/癌肉瘤)和分期(III/IV期)。

在针对PCS后残留病灶多少的荟萃分析中,高达52.1%的病例无肉眼残留病灶 (18项研究,1329位患者),75%的病例的残留病灶低于1cm (27项研究,2343位患者)

在IV期与III-IV期疾病的研究中,肿瘤细胞减少到上述两个阈值的比例都较低(NGRD:41.4% vs 69.8%;<1 cm:63.2% vs 82.2%),但没有明显的组织学差异。

肿瘤细胞减灭程度与无进展生存期(A)和总生存期(B)的相关性

在针对报告的危险比(HR)进行分析时,与NGRD相比,任何可见残留病灶与较差的无进展生存期和总生存期相关(HR分别是2.16, 95%CI 1.45-3.21;I2=68%和2.57, 95%CI 2.13-3.10;I2=1%);与残留病灶<1cm相比,残留病灶≥1cm与较差的无进展生存期和总生存期相关(HR分别是2.55, 95%CI 1.93-3.37;I2=63%和2.62, 95%CI 2.20-3.11;I2=15%)。仅限于高质量研究的敏感性分析结果一致。

总而言之,一定比例的接受PCS治疗的晚期子宫内膜癌患者有残留的肿瘤病灶,与较差的生存预后相关;换言之,大部分患者PCS后的残留肿瘤病灶较小(肉眼不可见或<1cm),与相对较好的无进展生存期和总生存期相关

原始出处:

Albright Benjamin B,Monuszko Karen A,Kaplan Samantha J et al. Primary cytoreductive surgery for advanced stage endometrial cancer: A systematic review and meta-analysis.[J] .Am J Obstet Gynecol, 2021, https://doi.org/10.1016/j.ajog.2021.04.254

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createdAvatar=null, createdBy=4e6121964459, createdName=diushouji, createdTime=Fri Oct 22 15:47:31 CST 2021, time=2021-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1708650, encodeId=01d71e08650bc, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Tue Feb 15 22:47:31 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313081, encodeId=82df131308196, content=<a href='/topic/show?id=4ce783062c7' target=_blank style='color:#2F92EE;'>#肿瘤细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, 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createdName=ms6000001009354872, createdTime=Wed May 19 13:41:19 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966831, encodeId=35dc966831f3, content=具体情况具体分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed May 19 11:17:08 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966793, encodeId=76ca966e93f0, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, 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  5. 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createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-19 12582d2fm84暂无昵称

    很好吧

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1640745, encodeId=86f31640e452a, content=<a href='/topic/show?id=502f5982060' target=_blank style='color:#2F92EE;'>#晚期子宫内膜癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59820, encryptionId=502f5982060, topicName=晚期子宫内膜癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=718a22711194, createdName=12498b08m97暂无昵称, createdTime=Fri Sep 17 13:47:31 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632960, encodeId=ed0b1632960c6, content=<a href='/topic/show?id=5f4a8306558' target=_blank style='color:#2F92EE;'>#肿瘤细胞减灭术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83065, encryptionId=5f4a8306558, topicName=肿瘤细胞减灭术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4e6121964459, createdName=diushouji, createdTime=Fri Oct 22 15:47:31 CST 2021, time=2021-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1708650, encodeId=01d71e08650bc, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Tue Feb 15 22:47:31 CST 2022, time=2022-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1313081, encodeId=82df131308196, content=<a href='/topic/show?id=4ce783062c7' target=_blank style='color:#2F92EE;'>#肿瘤细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83062, encryptionId=4ce783062c7, topicName=肿瘤细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Thu May 20 13:47:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966985, encodeId=efaa9669850c, content=很好吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0acb2570971, createdName=12582d2fm84暂无昵称, createdTime=Wed May 19 18:51:01 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966878, encodeId=ef169668e827, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a10f5504152, createdName=ms6000001009354872, createdTime=Wed May 19 13:41:19 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966831, encodeId=35dc966831f3, content=具体情况具体分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed May 19 11:17:08 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966793, encodeId=76ca966e93f0, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-19 ms6000001009354872

    学习

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1640745, encodeId=86f31640e452a, content=<a href='/topic/show?id=502f5982060' target=_blank style='color:#2F92EE;'>#晚期子宫内膜癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59820, encryptionId=502f5982060, topicName=晚期子宫内膜癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=718a22711194, createdName=12498b08m97暂无昵称, createdTime=Fri Sep 17 13:47:31 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632960, encodeId=ed0b1632960c6, content=<a href='/topic/show?id=5f4a8306558' target=_blank style='color:#2F92EE;'>#肿瘤细胞减灭术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83065, encryptionId=5f4a8306558, topicName=肿瘤细胞减灭术)], attachment=null, authenticateStatus=null, 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topicId=null, topicList=[TopicDto(id=83062, encryptionId=4ce783062c7, topicName=肿瘤细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Thu May 20 13:47:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966985, encodeId=efaa9669850c, content=很好吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0acb2570971, createdName=12582d2fm84暂无昵称, createdTime=Wed May 19 18:51:01 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966878, encodeId=ef169668e827, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a10f5504152, createdName=ms6000001009354872, createdTime=Wed May 19 13:41:19 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966831, encodeId=35dc966831f3, content=具体情况具体分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed May 19 11:17:08 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966793, encodeId=76ca966e93f0, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-19 易水河

    具体情况具体分析

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1640745, encodeId=86f31640e452a, content=<a href='/topic/show?id=502f5982060' target=_blank style='color:#2F92EE;'>#晚期子宫内膜癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59820, encryptionId=502f5982060, topicName=晚期子宫内膜癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=718a22711194, createdName=12498b08m97暂无昵称, createdTime=Fri Sep 17 13:47:31 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632960, encodeId=ed0b1632960c6, content=<a href='/topic/show?id=5f4a8306558' target=_blank style='color:#2F92EE;'>#肿瘤细胞减灭术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83065, encryptionId=5f4a8306558, topicName=肿瘤细胞减灭术)], attachment=null, authenticateStatus=null, 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createdName=ms6000001009354872, createdTime=Wed May 19 13:41:19 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966831, encodeId=35dc966831f3, content=具体情况具体分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed May 19 11:17:08 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966793, encodeId=76ca966e93f0, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-19 phoebeyan520

    学习了,谢谢

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1640745, encodeId=86f31640e452a, content=<a href='/topic/show?id=502f5982060' target=_blank style='color:#2F92EE;'>#晚期子宫内膜癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59820, encryptionId=502f5982060, topicName=晚期子宫内膜癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=718a22711194, createdName=12498b08m97暂无昵称, createdTime=Fri Sep 17 13:47:31 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632960, encodeId=ed0b1632960c6, content=<a href='/topic/show?id=5f4a8306558' target=_blank style='color:#2F92EE;'>#肿瘤细胞减灭术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83065, encryptionId=5f4a8306558, topicName=肿瘤细胞减灭术)], attachment=null, authenticateStatus=null, 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topicId=null, topicList=[TopicDto(id=83062, encryptionId=4ce783062c7, topicName=肿瘤细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Thu May 20 13:47:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966985, encodeId=efaa9669850c, content=很好吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0acb2570971, createdName=12582d2fm84暂无昵称, createdTime=Wed May 19 18:51:01 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966878, encodeId=ef169668e827, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a10f5504152, createdName=ms6000001009354872, createdTime=Wed May 19 13:41:19 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966831, encodeId=35dc966831f3, content=具体情况具体分析, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKibA62IFMeUJEmSyIe8DvYFeERuOsfrRd8iano7nENqQU1dRR3tqeQOUL3eqgYgEZRT2t2iaEsib0JEw/132, createdBy=66771693911, createdName=易水河, createdTime=Wed May 19 11:17:08 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966793, encodeId=76ca966e93f0, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1bb241978, createdName=phoebeyan520, createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-18 yulinkuahu

    学习了😆

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1640745, encodeId=86f31640e452a, content=<a href='/topic/show?id=502f5982060' target=_blank style='color:#2F92EE;'>#晚期子宫内膜癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59820, encryptionId=502f5982060, topicName=晚期子宫内膜癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=718a22711194, createdName=12498b08m97暂无昵称, createdTime=Fri Sep 17 13:47:31 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632960, encodeId=ed0b1632960c6, content=<a href='/topic/show?id=5f4a8306558' target=_blank style='color:#2F92EE;'>#肿瘤细胞减灭术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83065, encryptionId=5f4a8306558, topicName=肿瘤细胞减灭术)], attachment=null, authenticateStatus=null, 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topicId=null, topicList=[TopicDto(id=83062, encryptionId=4ce783062c7, topicName=肿瘤细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Thu May 20 13:47:31 CST 2021, time=2021-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966985, encodeId=efaa9669850c, content=很好吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0acb2570971, createdName=12582d2fm84暂无昵称, createdTime=Wed May 19 18:51:01 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966878, encodeId=ef169668e827, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a10f5504152, 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createdTime=Wed May 19 09:25:48 CST 2021, time=2021-05-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966711, encodeId=7dfb966e1118, content=学习了😆, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq1LVSLWQ27uw6z7cbBteOXyNaptoViaYI91EaNutzveAxsW0YBf37GE92vDTJ9zvYhxjRs96sGwsg/0, createdBy=8a4a1693746, createdName=yulinkuahu, createdTime=Tue May 18 23:46:00 CST 2021, time=2021-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=966695, encodeId=0b98966695d9, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210518/cd5ae48bc99d4e5b99357ba20b7ae160/700da5bab6de47cba94dcc7b36f23639.jpg, createdBy=f1831296933, createdName=ltxdsr810920, createdTime=Tue May 18 23:20:51 CST 2021, time=2021-05-18, status=1, ipAttribution=)]
    2021-05-18 ltxdsr810920

    学习

    0

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