w*******g
发帖数: 16 | 1 我岳父诊断为晚期胃癌并胃淋巴结转移，进行2/3胃切除和腹网膜清扫手术。现在为化
疗的第二个疗程。上周发现血清中碱性磷酸酶升高了近一倍，检查之后排除了骨转移。
请问各位有可能是什么原因引起碱性磷酸酶升高，有没有办法降低碱性磷酸酶的水平呢
？谢谢，不胜感激。 | l*h
发帖数: 4124 | 2 for this slight elevation of alkaline phosphatase during chemo of gastric
carcinoma, first suspect is typically liver toxicity. liver met and bone met
should also be suspected but the enzyme level is usually much higher when
the mets can be seen on imaging.
【在 w*******g 的大作中提到】
: 我岳父诊断为晚期胃癌并胃淋巴结转移，进行2/3胃切除和腹网膜清扫手术。现在为化
: 疗的第二个疗程。上周发现血清中碱性磷酸酶升高了近一倍，检查之后排除了骨转移。
: 请问各位有可能是什么原因引起碱性磷酸酶升高，有没有办法降低碱性磷酸酶的水平呢
: ？谢谢，不胜感激。
| l*h
发帖数: 4124 | 3 检查之后排除了骨转移
additional question: what test was done to achieve this, Tc-99m bone scan?
【在 w*******g 的大作中提到】
: 我岳父诊断为晚期胃癌并胃淋巴结转移，进行2/3胃切除和腹网膜清扫手术。现在为化
: 疗的第二个疗程。上周发现血清中碱性磷酸酶升高了近一倍，检查之后排除了骨转移。
: 请问各位有可能是什么原因引起碱性磷酸酶升高，有没有办法降低碱性磷酸酶的水平呢
: ？谢谢，不胜感激。
| w*******g
发帖数: 16 | | l*h
发帖数: 4124 | 5 it looks like doctors in China, when given a condition, only think about
possibilities that some expensive procedures can be done. i talked to quite
some in those biggest hospitals, they seemed genuinely not knowing those
more common, but no-expensive-procedure possibilities. they don't learn by
systematic learning, but only by casual chatting and hearsay. it look like
the vast majority of doctors in China are functioning this way.
not certain what regimen is being used (there are so many for gastric
carcinoma because none is super effective). but the level of ALP, if
isolated or accompanied by also slight elevation of other enzymes, is not
high enough to discontinue chemo but rather calls for closer monitoring. but
the decision, should be made by the doctor who knows her overall condition
well.
if the lab is capable, isozyme (subtype) levels can be tested to get a
better idea about its source.
【在 w*******g 的大作中提到】
: 谢谢lmh. 是te-99 骨扫瞄。
| w*******g
发帖数: 16 | 6 Thanks very much for your kind reply, lmh. That's really helpful. You are
right, doctors in China may prefer the expensive way which can increase the
earnings. |
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