作者nolyab (nolyab)
看板Anti-Cancer
标题Re: [问题] 摄护腺切片报告
时间Mon Jun 15 19:57:05 2026
今天回诊医师说正子摄影看起来已经骨转移了(但淋巴没有看到），建议口服及注射健保
给付的荷尔蒙。
MRI报告:左侧肿瘤4*4*5cm,T3aN0MX
1. 请问骨转移是不是真的就不建议开刀了？後续需要转看肿瘤科吗？
2. 询问医师可以控制多久，医师没有给明确的答覆，希望有病友可以分享一下後续的治
疗及存活时间，感激不尽
6/16今天去申请PSMA病历报告，心理有一点底…似乎只能荷尔蒙治疗了？
但还是很不能接受PSA才29，竟然已经转移5个地方了…
Impression:
묠PROMISE miTM classification: miT3aNOM1b(diss), BCR restaging
묠Compatible with prostate cancer with bone metastasis at the following PSMA-a
vid areas (PSMA-RADS
5). Clinical correlation is recommended:
margin, rostate bed (PRIMARY 3): LB, LM (with possible extracapsular extension
at left anterior
-- the skeleton: the skull, the left scapula, the L5 vertebra, the bil. ilia.
묠Increased PSMA uptake a t:
- the left 8th rib may be due to bone metastasis, though trauma, unspecific bo
ne uptake or inflammation can be this picture. (PSMA-RADS 3B)
-- the LUL and RUL (3 foci) of lung maybe due to inflammation/infection, thoug
h lung metastasis cannot be ruled out (PSMA-RADS 3C). Suggest further evaluati
on or close follow-up.
RADS 2 right bucco-facial area may be due to infection/inflammation. Tumor is
less likely (PSMA-
-- the other parts of the bilateral ribs may be due to unspecific bone uptake
or less likely bone metastasis (PSMA-RADS 2).
> Other image findings as above descriptions.
묠No definite evidence of PSMA-avid tumor is demonstrated elsewhere. Tumor wit
h tiny size, poor PSMA-avidity or obscured by physiological activity can't be
ruled out. Clinical correlation is recommended.
※ 引述《nolyab (nolyab)》之铭言：
: 家父70岁，PSA:29.29，
: 切片报告显示格里森4+4，
: 1.切片报告看不太了解，想请问这能够推估大概第几期吗？好让自己心里有个底
: PATH. DX.: 1. Prostate, left, punch biopsy --- Adenocarcinoma,
: Gleason's score: 4+4=8, Grade group 4 （3/6. 5%）. 2. Prostate, right，
: punch biopsy -- No malignancy. Ancillary study for diagnosis: 1:
: Immunohistochemistry stains for HMWCK (loss of basal cells) and alpha-methyl
ac
: yl-CoA racemase (+) done in section A. 2.
: Immunohistochemistry stains for HMWCK (highlight preserved basal cells) and
al
: pha-methylacyl-CoA racemase (-) done in section B.
: Gross description: The specimen consists of 1) 6 strips of gray white soft t
is
: sue, up to 1.7x0.1x0.1 cm, labeled as "left". All for section: B. 2) 6 strip
s
: of gray white soft tissue, up to 1.9x0.1x0.1 cm, labeled as "right".
: All for section: A. Microscopic description: 1. Section shows focal prostate
t
: umor with ill-defined glands exhibiting poorly-formed glandular lumina, and
ci
: rcumscribed cribriform glands. 2. Section shows prostate tissue with variabl
y
: glandular hyperplasia. No evidence of malignancy is seen: Note: This case ha
s
: been peer reviewed by two doctors.
: 2.医师说切片完要再等一个月才能做MRI，想请问这一个月我们能做什麽？
: 3.看切片报告时，有打一只荷尔蒙针。想请问这是表示不太乐观的意思吗？（因为查网
路
: 都是说荷尔蒙疗法属於最後一线才使用）
: 4.彰基的陈俊吉医师不知道有没有人看过，因目前苦恼於不知道要找那个医师
: 感谢各位癌友及家属，第一次遇到亲人罹癌真的不知道该怎麽办
--
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1F：推 mystery7631: 即便不手术，也可以用最新纳入给付的SBRT高剂量五天 06/15 21:47
2F：→ mystery7631: 照下原发部位（原发部位健保给付），然後自费SBRT照06/15 21:47
3F：→ mystery7631: 转移部位，配合吃二代+ADT打针，这样应该是最积极的 06/15 21:47
4F：→ mystery7631: 疗法了，如果医生不愿积极治疗我觉得可以换医生没问 06/15 21:47
5F：→ mystery7631: 题06/15 21:47
6F：→ mystery7631: PSA 29不一定有转移 别放弃局部的积极治疗 06/15 21:48
7F：→ mystery7631: 如果是照F-18 PET/CT 伪影机率很高（高达2/3是伪影）06/15 21:53
8F：→ mystery7631: 我自己是会寻求积极治疗（放射或手术皆可，若真的小 06/15 21:53
9F：→ mystery7631: 转移我比较推放疗，比较不伤身）06/15 21:53
10F：推 kennyluck: 有样本可以去做个基因检测 ASCO刚有新结果 06/16 02:31
※ 编辑: nolyab (1.168.232.68 台湾), 06/16/2026 14:33:22
11F：→ mystery7631: 虽然不甘心，但这样的报告应该是能健保申请二代荷尔 06/16 19:48
12F：→ mystery7631: 蒙了（大於3处，一处非中轴骨）一个月可以省5-6万三 06/16 19:48
13F：→ mystery7631: 年月200万药费，能的话请医生申请最新也最贵的daralu 06/16 19:48
14F：→ mystery7631: tamide，副作用最小 06/16 19:48
15F：推 mystery7631: darolutamide 药不会进脑部，所以副作用最少，但也 06/16 19:52
16F：→ mystery7631: 最贵自费一个月要近7万，次之选Xtandi 再其他的就不 06/16 19:52
17F：→ mystery7631: 要了 06/16 19:52