作者terry881112 (屁孩)
看板Anti-Cancer
標題[問題] 肺腺癌術後後續治療及相關問題
時間Tue Aug 20 16:10:30 2024
第一次在抗癌版發文
目前媽媽53歲，先前健檢照LDCT的時候照到右肺三公分的GGO及其他不到一公分的小結節及左
肺也有其他不到一公分的結節，目前已經開刀拿掉右肺上的結節，病理報告如下
Lung, right upper lobe, S1 segmentectomy, minimally invasive adenocarcinoma and
adenocarcinoma in situ. (staging with right lower lobe, minimally invasive adeno
carcinoma)(mpT1miN0Mb) Pleura, right, pleurectomy, chronic lymphocytic inflammat
ion. Lymph nodes, sites specified as below, lymphadenectomy, free of cancer meta
stasis. SUMMARY OF GROSS AND MICROSCOPIC FINDINGS: Tumor type: minimally invasiv
e adenocarcinoma, nonmucinous. Histologic grade: well differentiated. Tumor loca
tion: right upper lobe. Tumor size: Total tumor size:(MIA)1.9x1.6x1.0 and (AIS)0
.7x0.4x0.4 cm, Invasive tumor size:0.3 cm. Tumor Focality: Separate tumor nodule
s in different lobes: right upper lobe AIS, right lower lobe MIA. Lymphovascular
Invasion: Not identified. Perineural invasion: Not identified. Spread Through A
ir Spaces (STAS): Not identified. Main bronchus: not included. Pleura: The pleur
a is free from tumor (type PL0). Non-neoplastic lung: There are multiple subpleu
ral chronic lympocytic inflammation, fibrosis, bronchiectatic change, mucous plu
gs with granulmatous inflammation and reactive respiratory metaplasia. There is
focal lymphocytic pleuritis. Margins: All margins are uninvolved by carcinoma, s
pecify closest margin: parenchymal margin, distance:3mm. Bronchial margin: not i
nvolved. Vascular margin: not involved. Parenchymal margin: not involved. Lymph
node status: no evidence of metastasis. N2: group 7: 0/3; group 9: 0/2; group3:
0/3; Extranodal Extension: Not identified. TNM Descriptors: m (multiple primary
tumors). Primary Tumor (pT): pT1mi: Minimally invasive adenocarcinoma: adenocarc
inoma (≦3 cm in
醫生說明因為切下來的兩顆都不是原位癌，原則上兩顆都是各自原發的，但醫生看有點多顆
左肺上也有其他結節，怕有可能是同一病灶，所以建議術後輔助治療，口服化療或是用注射
的都可以
想請問因為我看報告上是說一顆是MIA一顆是AIS，不過我看網路上及文獻說AIS也算是原位癌
的其中一種，不曉得醫生是有沒有其他的考慮才說不是原位癌的？
還有這種狀況的五年復發率會不會跟一般的MIA有差？
病人一直很焦慮，所以才想上來問一下，謝謝大家了！
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4F：→ terry881112: 完整病理報告出來了 應該兩處都是MIA才對！ 08/20 19:00
5F：推 hyperboy1092: 預後很好，觀察追蹤就好。 08/20 20:29
6F：推 rexru: 建議加入臉書肺長壽，這是肺腺癌病友及家屬的團體，裡面有 08/21 01:37
7F：→ rexru: 很多資訊可供參考 08/21 01:37
8F：→ terry881112: 感謝h大跟r大回覆，相關社團有加入了，會在跟醫生討 08/21 09:40
9F：→ terry881112: 論看看 08/21 09:40
10F：推 Euglena: 1.9公分那顆是MIA，0.7公分那顆是AIS。 08/22 15:40