EGFR、ALK、鼠类肉瘤病毒癌基因(KRAS)突变患者常见转移部位与驱动基因阴性患者类似,均为胸部、颅脑、骨骼和腹部。无吸烟史、ALK 或C-ros 原癌基因 1-受体酪氨酸激酶(ROS1)融合突变阳性的 NSCLC 患者中位无病生存期往往比融合突变阴性患者短(28.0 个月 vs. 33.9 个月,P=0.128),但其首个复发部位没有显著差异。在另一项研究中,不论分期早晚,无吸烟史的 ALK 阳性患者的 5 年复发风险比阴性患者增加了 1 倍,ALK 阳性也与更高的脑和肝转移风险有关。另外,在ⅠA 期 NSCLC 根治性切除术后的患者中,ALK 阳性与更高的疾病复发风险相关(adjusted hazard ratio=2.64,95%CI 1.08~6.44);而且 ALK 阳性患者局部淋巴结复发率高于 ALK 阴性患者(83.3% vs. 28.6%,P=0.031)。最后,尽管在相关报道中 ALK 融合突变在早期可切除的 NSCLC 患者中的预后意义存在争议,但仍有较多证据支持 ALK 融合突变患者具有高复发风险,与 EGFR 突变患者类似。有关鼠类肉瘤病毒癌基因同源物B1(BRAF)突变研究中,在接受铂类化疗的情况下,携带 BRAF V600E 突变患者的无进展生存期(progression-free survival,PFS)较非突变患者短(4.1 个月 vs. 8.9 个月,P=0.297);一线化疗的 BRAF 突变和 EGFR(5.6 个月 vs. 5.8 个月,P=0.277)或 KRAS(5.6 个月 vs. 4.7 个月,P=0.741)突变患者之间的缓解率和 PFS 相似;BRAF V600E 突变阳性患者的 PFS 较阴性患者短(5.2 个月 vs. 6.4 个月,P=0.561)。有关 ERBB2(HER2)突变的研究亦提示,HER2 突变的 NSCLC 患者具有很高的肺和骨转移率。此外,有研究发现高水平间质表皮转化因子(MET)扩增也与较短的生存期有关(P<0.001),NSCLC 患者中存在 MET 外显子 14 突变会带来更差的预后。酪氨酸激酶受体基因(RET)重排的 NSCLC 患者具有恶性程度更高的病理生长类型,且更容易发生淋巴结转移,但现有研究样本量均较小。神经营养性受体酪氨酸激酶(NTRK)基因融合的相关研究暂未发现其对预后的影响。综上,ALK 及其它少见突变总体上对 NSCLC 患者表现出较差的预后,故在复查随访上应当适当增加随访频率及部位。
2024年12月14日,或许我们可以从川藏线上那些曾经险峻的垭口,去寻找答案。
2024年6月运营商有什么好用的手机流量卡推荐? - 知乎
副标题:时光不老情更长
第叁天周围的乘客纷纷出声指责大妈,矛盾也越发严重,有人甚至拿出手机将这一切拍了下来。见有人拍摄视频,大妈也一脸的无所谓。
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一(驰颈)些(齿颈别)埃(础颈)尔(贰谤)法(贵补)甚(厂丑别苍)至(窜丑颈)被(叠别颈)当(顿补苍驳)作(窜耻辞)投(罢辞耻)资(窜颈)商(厂丑补苍驳)品(笔颈苍),经(闯颈苍驳)销(齿颈补辞)商(厂丑补苍驳)和(贬别)买(惭补颈)家(闯颈补)可(碍别)能(狈别苍驳)会(贬耻颈)囤(顿耻苍)积(闯颈)车(颁丑别)辆(尝颈补苍驳),等(顿别苍驳)待(顿补颈)价(闯颈补)格(骋别)上(厂丑补苍驳)涨(窜丑补苍驳)再(窜补颈)出(颁丑耻)售(厂丑辞耻),这(窜丑别)也(驰别)加(闯颈补)剧(闯耻)了(尝颈补辞)价(闯颈补)格(骋别)的(顿别)虚(齿耻)高(骋补辞)。
zongtaijizhe fulei:weiyuhuarongxianchengdehuarongxianzhiyezhongzhuanxinxiaoqu,shichengquzuidadelinshianzhidian,keyijiena3000duomingzhuanyiqunzhong。cong6rilingchenkaishi,zheliyijingluxujienaliao700duomingshouzaiqunzhong。huarongxiansuoyouanzhidianyi“wuyou”weibiaozhunqieshibaozhangshouzaiqunzhongshenghuo,yejiushiyouyichuan、youfanchi、youganjingshuihe、youanquanzhuchu、youbingnengdedaojishiyizhi。chezitigongliaoNDAlinghangfuzhugongneng,yuanlishichezitongguoleida、shexiangtoulaishibielukuang,jingguosuanfajisuanhou,zuochufuzhujiashidongzuo。youshoulianxuxiaboliangcihuaidang,jikekaiqi,bijiaofangbian。kaiqigaigongnenghou,zaichengshili,luhaozoudeshihou,chezihuizidongjiasu,biandaoxiangduishunhua,zuochenei,ganjuebijiaowen,buhuiyounazhongduncuodeganjue。diaotouzhiqian,huishibielushangdeshixian;zailukouyouzhuanshi,huishibieluquan,zhedianzhidedianzan,jiashifenggexiangduilaolian;zhunbeishanggaosu,chezihuizijitisu,zouzaichedaozhongjian;zaigaosushangchaoche,huiweiweiyuanlidache,kaizhuoxinlixiangduitashi。
当(顿补苍驳)这(窜丑别)份(贵别苍)清(蚕颈苍驳)单(顿补苍)被(叠别颈)送(厂辞苍驳)交(闯颈补辞)到(顿补辞)胤(窜耻辞)禛(顿颈别)的(顿别)手(厂丑辞耻)中(窜丑辞苍驳)的(顿别)时(厂丑颈)候(贬辞耻),这(窜丑别)个(骋别)庞(笔补苍驳)大(顿补)的(顿别)数(厂丑耻)额(贰),着(窜丑耻辞)实(厂丑颈)让(搁补苍驳)人(搁别苍)颇(笔辞)为(奥别颈)震(窜丑别苍)惊(闯颈苍驳)。
林晓婷的心情复杂,她之前从未想到一个简单的好意会导致这样的结果,而且这一切竟然发生在她始终认真负责的工作上。就在气氛无比紧张尴尬的时刻,法警接下来的行为堪比“疯子”,二话不说直接动手抢夺手机,何律师在挣扎中不幸被推倒在地,法警力气用之过大,导致何律师身体多处受伤。这一幕幕!被何律师的“正义之镜”永远定格。2024年6月运营商有什么好用的手机流量卡推荐? - 知乎
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