d**e 发帖数: 28 | 1 爸爸二月份做了直肠癌的手术,之后一直在做化疗。前两天全面检查了一次,腹部增强
ct报告出来,结论是跟上次(手术后化疗前作过一次腹部增强ct)无明显变化,但是肺
部多发小结节增多. 跟爸的主治医生谈了谈,他倒是很乐观(可我觉得有些盲目,或者
凭他的经验觉得没什么大问题),他说之前的化疗是有效果的,现在看应该继续以前的
方案做下去。我问那肺部结节是怎么回事?他说目前不能百分之百确定是转移,但他觉
得可能性不大,可也不敢保证不是,只能每三个月作一次腹部增强ct,随时监测。
跟他谈完并没有解答我的疑问,我总是觉得不应该这么消极地等待下去。到底要不要做
全面的检查?(但是医生说小结节太小,都做不了穿刺)。不知道有没有人可以提供一
些建议和看法。在此多谢了!
这是CT的报告结果:
双肺多发小结节较前增多,右肺上叶后段及左肺下叶后基底段小结节为新发,余未见明
显变化;
左肺下叶索条;
双侧胸膜增厚,未见明显变化;
肝右后叶小低密度影,同前;
胆囊结石,未见明显变化;
脾大,较前增大;
直肠癌术后改变,术区软组织密度影,未见明显变化;
前列腺内钙化灶;
余未见明显变化。
肝右后叶小囊肿可能。
另外一个 | g***r 发帖数: 285 | 2 probably metastatic disease, can get a PET scan and see if there is
increased uptake, | g***r 发帖数: 285 | 3
liver
intestinal tract drains through portal system so most of the time when
intestinal cancer spreads, it often involves liver first, then lungs and
brain and other organ systems later,
however, distal rectal cancer drains through inferior rectal vein that
drains directly into inferior vena cava, so it could spare the liver and
spread to lungs first, | d**e 发帖数: 28 | 4 多谢gomer的回复,有朋友说:
做pet不能区分炎症和肿瘤,所以说做了也不能确诊。
不知道是不是这样。
不过现在这种情况,只好尽一切的努力。
可气的是那个主治医师还那么乐观,根本就没有进一步会诊的意思。
【在 g***r 的大作中提到】![](/moin_static193/solenoid/img/up.png) : probably metastatic disease, can get a PET scan and see if there is : increased uptake,
| g***r 发帖数: 285 | 5
depends on the scale on pet scan, i was told once but forgot the exact cut
off to be considered highly likely to be malignant, maybe it's 2 or
something like that,
anyway, the basic theory is that with cancer, there is increased uptake of
nutrients and metabolic activities at the cancer site; sometimes
inflammatory conditions such as infection can also show increased uptake,
then you have to look at the patient to see if there is any signs to suggest
lung infection,
so in a way PET scan or any
【在 d**e 的大作中提到】![](/moin_static193/solenoid/img/up.png) : 多谢gomer的回复,有朋友说: : 做pet不能区分炎症和肿瘤,所以说做了也不能确诊。 : 不知道是不是这样。 : 不过现在这种情况,只好尽一切的努力。 : 可气的是那个主治医师还那么乐观,根本就没有进一步会诊的意思。
| d**e 发帖数: 28 | 6 多谢你的信息!我们也会尽快安排一个PET检查。
上一次CT是在4个月以前,刚刚做过手术后,当时肺部没有发现什么异常。一个好消息
是这次检查,肿瘤标志物的值均在正常范围内。
suggest
will
【在 g***r 的大作中提到】![](/moin_static193/solenoid/img/up.png) : : depends on the scale on pet scan, i was told once but forgot the exact cut : off to be considered highly likely to be malignant, maybe it's 2 or : something like that, : anyway, the basic theory is that with cancer, there is increased uptake of : nutrients and metabolic activities at the cancer site; sometimes : inflammatory conditions such as infection can also show increased uptake, : then you have to look at the patient to see if there is any signs to suggest : lung infection, : so in a way PET scan or any
| y********g 发帖数: 3097 | |
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