社区 › 肝胆分区 › 肝内胆管癌

315676024 发表于 2017-3-20 21:34:38

父亲目前刚刚检查出，各项指标良好，ca199和afp都在标准内，只有癌胚4.88超标一点，无任何不适症状，目前在医院口服化疗药进行治疗，但医生诊断为胆管癌晚期，肝外胰腺部位淋巴结转移，后腹部转移。目前很困扰，口服化疗药时间较短效果不明，想使用靶向药，但看起来副作用较大，目前我父亲这种情况是否应该使用呢？由于发现时间较短，很多检查都没有做，下周准备做活体检测，基因检测和免疫组化。看了您的帖子和身边靶向药的使用者，信心增加，但同时担心副作用，不知免疫治疗方面是否可行同时生存质量更高呢？我父亲有8年的肝硬化病史，担心使用药物对于他的肝损伤过大反而适得其反，但又不愿意听从医院的，化疗，介入，中药，等死。。。十分纠结困扰
项目                          范围        2月27日        3月20日        变动比
备注                               
CA199                  0-27         1.7               
癌胚                          0-4.7          4.88               
AFP甲胎                  0-27        1.7                  1.67        -1.76%
羟丁酸脱氢酶         72-182        111               
同型半胱氨酸&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp; <15&nbsp; &nbsp; &nbsp; &nbsp; 30.22&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
乳酸脱氢酶&nbsp; &nbsp;&nbsp; &nbsp; &nbsp; &nbsp; 15-65&nbsp; &nbsp; &nbsp; &nbsp; 47&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
APTT凝血活酶&nbsp; &nbsp; &nbsp; &nbsp; 22.7-31.8&nbsp; &nbsp; &nbsp; &nbsp; 22.1&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;30.8&nbsp; &nbsp; &nbsp; &nbsp; 39.37%
碱性磷酸酶&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;45-125&nbsp; &nbsp; &nbsp; &nbsp; 175&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 145.6&nbsp; &nbsp; &nbsp; &nbsp; -16.80%
AST&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;15-40&nbsp; &nbsp; &nbsp; &nbsp; 19.2&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 19.1&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;-0.52%
ALT&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;9-50&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;17.4&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 23.2 &nbsp; &nbsp; &nbsp; &nbsp; 33.33%
总胆汁酸&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;0-10&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 5.68&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;5.8&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;2.11%
总胆红素&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;5.13-18.8&nbsp; &nbsp; &nbsp; &nbsp; 10.2&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;8&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;-21.57%
直接胆红素 &nbsp; &nbsp; &nbsp; &nbsp; 1.71-6.84&nbsp; &nbsp; &nbsp; &nbsp; 2.9 &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 3.5&nbsp; &nbsp; &nbsp; &nbsp; 20.69%
间接胆红素&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;1.7-12&nbsp; &nbsp; &nbsp; &nbsp; 7.3&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
肌酐&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 40-106&nbsp; &nbsp; &nbsp; &nbsp; 93&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;93.6&nbsp; &nbsp; &nbsp; &nbsp; 0.65%
甘油三脂&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;<1.7&nbsp; &nbsp; &nbsp; &nbsp; 1.26&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
总蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;65-85&nbsp; &nbsp; &nbsp; &nbsp; 80.3&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;62.1&nbsp; &nbsp; &nbsp; &nbsp; -22.67%
白蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;40-55&nbsp; &nbsp; &nbsp; &nbsp; 48.6&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;40.3&nbsp; &nbsp; &nbsp; &nbsp; -17.08%
球蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;1.2-2.4&nbsp; &nbsp; &nbsp; &nbsp; 1.53&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
白细胞&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;3.5-9.5&nbsp; &nbsp; &nbsp; &nbsp; 7.5&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;6.05&nbsp; &nbsp; &nbsp; &nbsp; -19.33%
血红蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 130-175&nbsp; &nbsp; &nbsp; &nbsp; 158&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;133&nbsp; &nbsp; &nbsp; &nbsp; -15.82%
淋巴细胞&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;1.1-3.2&nbsp; &nbsp; &nbsp; &nbsp; 1.98&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;1.27&nbsp; &nbsp; &nbsp; &nbsp; -35.86%
血小板&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;125-350&nbsp; &nbsp; &nbsp; &nbsp; 237&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;197&nbsp; &nbsp; &nbsp; &nbsp; -16.88%


目前还未进行其他治疗，口服替吉奥，准备周三做个活体和基因检测，同时做血管造影看看能不能做栓塞。谢谢指教

315676024 发表于 2017-3-20 21:35:44

父亲目前刚刚检查出，各项指标良好，ca199和afp都在标准内，只有癌胚4.88超标一点，无任何不适症状，目前在医院口服化疗药进行治疗，但医生诊断为胆管癌晚期，肝外胰腺部位淋巴结转移，后腹部转移。目前很困扰，口服化疗药时间较短效果不明，想使用靶向药，但看起来副作用较大，目前我父亲这种情况是否应该使用呢？由于发现时间较短，很多检查都没有做，下周准备做活体检测，基因检测和免疫组化。看了您的帖子和身边靶向药的使用者，信心增加，但同时担心副作用，不知免疫治疗方面是否可行同时生存质量更高呢？我父亲有8年的肝硬化病史，担心使用药物对于他的肝损伤过大反而适得其反，但又不愿意听从医院的，化疗，介入，中药，等死。。。十分纠结困扰
项目&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 范围&nbsp; &nbsp; &nbsp; &nbsp; 2月27日&nbsp; &nbsp; &nbsp; &nbsp; 3月20日&nbsp; &nbsp; &nbsp; &nbsp; 变动比
备注&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
CA199&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;0-27&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;1.7&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
癌胚&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 0-4.7&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; 4.88&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
AFP甲胎&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;0-27&nbsp; &nbsp; &nbsp; &nbsp; 1.7&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;1.67&nbsp; &nbsp; &nbsp; &nbsp; -1.76%
羟丁酸脱氢酶&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;72-182&nbsp; &nbsp; &nbsp; &nbsp; 111&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
同型半胱氨酸&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp; <15&nbsp; &nbsp; &nbsp; &nbsp; 30.22&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
乳酸脱氢酶&nbsp; &nbsp;&nbsp; &nbsp; &nbsp; &nbsp; 15-65&nbsp; &nbsp; &nbsp; &nbsp; 47&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
APTT凝血活酶&nbsp; &nbsp; &nbsp; &nbsp; 22.7-31.8&nbsp; &nbsp; &nbsp; &nbsp; 22.1&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;30.8&nbsp; &nbsp; &nbsp; &nbsp; 39.37%
碱性磷酸酶&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;45-125&nbsp; &nbsp; &nbsp; &nbsp; 175&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 145.6&nbsp; &nbsp; &nbsp; &nbsp; -16.80%
AST&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;15-40&nbsp; &nbsp; &nbsp; &nbsp; 19.2&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 19.1&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;-0.52%
ALT&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;9-50&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;17.4&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 23.2 &nbsp; &nbsp; &nbsp; &nbsp; 33.33%
总胆汁酸&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;0-10&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 5.68&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp;5.8&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;2.11%
总胆红素&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;5.13-18.8&nbsp; &nbsp; &nbsp; &nbsp; 10.2&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;8&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;-21.57%
直接胆红素 &nbsp; &nbsp; &nbsp; &nbsp; 1.71-6.84&nbsp; &nbsp; &nbsp; &nbsp; 2.9 &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 3.5&nbsp; &nbsp; &nbsp; &nbsp; 20.69%
间接胆红素&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;1.7-12&nbsp; &nbsp; &nbsp; &nbsp; 7.3&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
肌酐&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 40-106&nbsp; &nbsp; &nbsp; &nbsp; 93&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;93.6&nbsp; &nbsp; &nbsp; &nbsp; 0.65%
甘油三脂&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;<1.7&nbsp; &nbsp; &nbsp; &nbsp; 1.26&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
总蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;65-85&nbsp; &nbsp; &nbsp; &nbsp; 80.3&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;62.1&nbsp; &nbsp; &nbsp; &nbsp; -22.67%
白蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;40-55&nbsp; &nbsp; &nbsp; &nbsp; 48.6&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;40.3&nbsp; &nbsp; &nbsp; &nbsp; -17.08%
球蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;1.2-2.4&nbsp; &nbsp; &nbsp; &nbsp; 1.53&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
白细胞&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;3.5-9.5&nbsp; &nbsp; &nbsp; &nbsp; 7.5&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;6.05&nbsp; &nbsp; &nbsp; &nbsp; -19.33%
血红蛋白&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp; 130-175&nbsp; &nbsp; &nbsp; &nbsp; 158&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;133&nbsp; &nbsp; &nbsp; &nbsp; -15.82%
淋巴细胞&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;1.1-3.2&nbsp; &nbsp; &nbsp; &nbsp; 1.98&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;1.27&nbsp; &nbsp; &nbsp; &nbsp; -35.86%
血小板&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;125-350&nbsp; &nbsp; &nbsp; &nbsp; 237&nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp; &nbsp;197&nbsp; &nbsp; &nbsp; &nbsp; -16.88%

目前还未进行其他治疗，口服替吉奥，准备周三做个活体和基因检测，同时做血管造影看看能不能做栓塞。谢谢指教

315676024 发表于 2017-3-20 21:37:02

为什么发过来就是乱码。。。。
我新开一个帖子，麻烦指教
求助深蓝，该先做PD1还是直接靶向
http://www.yuaigongwu.com/forum.php?mod=viewthread&tid=35780&fromuid=60654
(出处: 与癌共舞)

lj.123456 发表于 2017-3-23 22:57:15

如果什么药都吃不下，还有没有别的方法进行治疗

13119195252 发表于 2017-3-24 19:32:11

大家好，我爸也是刚检查出来胆管ca，晚期，已经出现黄疸，消瘦症状，请问大家买的靶向药是通过什么途径买的

13119195252 发表于 2017-3-25 15:49:29

请问楼主，你的药在哪里买到换，我父亲也确诊了胆管癌晚期，已出现黄疸，医院说要架支架，我想以防万一，先买点药，同时想您提点建议，万分感谢

13119195252 发表于 2017-3-26 14:02:47

深蓝，您好，我爸也诊断出胆管癌晚期，出现黄疸了，人也消瘦，医院给出的治疗方案是先治黄疸，先打支架，把管壁撑大，我现在可以先用靶向药吗，请问靶向药的购买渠道，恳请您的帮助，成分感谢

永不放弃mom 发表于 2017-4-24 13:27:48

平安！ 发表于 2011-7-27 22:20 static/image/common/back.gif
我来泼一瓢冷水,莫怪哦。
癌症的信号通路哪有那么简单? 就只有EGF、VEGF、C-met、K-Ras 啊？
光是细胞膜 ...

标记一下，感觉真的很复杂

景程不错 发表于 2017-5-1 16:56:25

yrchenmo 发表于 2012-9-21 09:39
请教bluest，针对肝门胆管CA，替吉奥、希罗达、特罗凯、2992哪种比较合适？各有什么区别呢？我看伯母好像没 ...

替吉奥
我老爸在术后第6个月
开始吃
吃了10粒
血常规的白细胞从9600
陡降到3000
立即被我阻止继续服用了
现在家里还有16粒

射手王 发表于 2017-5-29 08:14:17

病友们大家加微信群交流

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