最简单办法读懂结直肠癌病理报告单
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">结直肠癌手术后病理报告单是手术治疗后最<span style="color: black;">要紧</span>的<span style="color: black;">检测</span>结果，<span style="color: black;">非常多</span><span style="color: black;">伴侣</span>“我就想<span style="color: black;">晓得</span><span style="color: black;">初期</span>、中期还是晚期，搞<span style="color: black;">那样</span>大一堆字还没一个结果，是不是故意不让<span style="color: black;">咱们</span>看懂哦？”，今天朱<span style="color: black;">大夫</span>教<span style="color: black;">大众</span>简单读懂这个报告。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-59c476b40a999a995bfc64ebfeba4597_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一般</span>病理报告单分为四个部分：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、基本信息（绿色区域）：有的时候肿瘤术后病检报告会有两份，第二份<span style="color: black;">增多</span>了免疫组化的结果。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、肉眼所见（黄色区域）：<span style="color: black;">便是</span>切除的肿瘤标本长啥样子，手感<span style="color: black;">怎样</span>，拿尺子量一量<span style="color: black;">体积</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、镜检病变要点（红色区域）：肿瘤近距离照片和<span style="color: black;">重要</span>部位的显微镜<span style="color: black;">影像</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4、病理诊断（蓝色区域）：诊断结果。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-415087ffd2ecaa77fafeba0a58a695a5_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">既然是简单读懂，那<span style="color: black;">咱们</span>就直接看最核心区域--蓝色区域</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">核心数据如下四个：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">1、肿瘤分化程度：高分化、中分化、低分化、未分化(恶性程度从左到右，由低到高)</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">2、肿瘤侵及层次：<span style="color: black;">便是</span>TNM分期中的T分期（T1粘膜下层 T2固有肌层 T3侵透固有肌层到达浆膜下层 T4穿透浆膜层）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">3、淋巴结：看阳性数，这是TNM分期中的N（N0=0枚阳性 N1=1-3枚阳性 N2=4枚以上）</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">4、TNM中的M<span style="color: black;">指的是</span><span style="color: black;">是不是</span><span style="color: black;">出现</span>远处转移，这是<span style="color: black;">经过</span>手术前<span style="color: black;">加强</span>CT观察<span style="color: black;">是不是</span>有肝转移、肺转移等（M0=<span style="color: black;">无</span>转移 M1=有远处器官转移）</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-eb0067cc70c3402cd0ca23d568db088b_720w.webp" style="width: 50%; margin-bottom: 20px;"></div><span style="color: black;">能够</span><span style="color: black;">按照</span>TNM分期在表中<span style="color: black;">查找</span>5年<span style="color: black;">存活</span>率（这<span style="color: black;">指的是</span>接受必要的放化疗后）<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">按照</span>病理结果和术前<span style="color: black;">加强</span>CT等<span style="color: black;">检测</span><span style="color: black;">咱们</span>做出了TNM分期，<span style="color: black;">这儿</span><span style="color: black;">咱们</span>怎么判断是早中晚呢？其实<span style="color: black;">初期</span>、中期、晚期是民间的说法，教科书上并<span style="color: black;">无</span><span style="color: black;">这般</span>划分癌症，为了便于交流，我<span style="color: black;">一般</span>用DUKES分期来分早中晚：</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Dukes A期：Stage1（<span style="color: black;">初期</span>） T1N0M0 T2N0M0</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Dukes B期：Stage2（中期偏早） T3N0M0 T4N0M0</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Dukes C期：Stage3（中期偏晚） 只要N为阳性（N=1<span style="color: black;">或</span>2），M0</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">Dukes D期：Stage4（晚期） 只要有M1</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-d0d732190ca08902b9e4f9e616a4a32b_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>AJCC TNM与Dukes评分对应参照表<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic4.zhimg.com/80/v2-fee21b4c410dba5f54be508b836732ef_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>Colon cancer staging 2018<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">当然了，早中晚分期更利于理解，而更<span style="color: black;">仔细</span>的TNM分期才<span style="color: black;">指的是</span>导临床<span style="color: black;">大夫</span>对癌症治疗策略<span style="color: black;">方法</span>制定的<span style="color: black;">基本</span>，<span style="color: black;">繁杂</span>的病理报告每一个细节都<span style="color: black;">包含</span>了丰富的信息，每一项都<span style="color: black;">能够</span>展开来讲，<span style="color: black;">倘若</span><span style="color: black;">大众</span>感兴趣，下一次<span style="color: black;">咱们</span><span style="color: black;">能够</span>深入聊一聊。</p>
<div style="color: black; text-align: left; margin-bottom: 10px;"><img src="https://pic2.zhimg.com/80/v2-8445a799f948293abca19a30edf56009_720w.webp" style="width: 50%; margin-bottom: 20px;"></div>
你的见解独到，让我受益匪浅，非常感谢。 认真阅读了楼主的帖子，非常有益。
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