(E) | 1. |
肺腫瘤的治療選項,上皮生長因子接受體(EGFR, epidermal growth factor receptor)的小分子抑制劑藥物是重要的選擇。下列何種病人肺腫瘤有「EGFR突變」的機率最高?
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A. | A 35-year-old woman with a carcinoid tumor |
B. | A 25-year-old man with a hamartoma |
C. | A 75-year-old man with squamous cell carcinoma and a history of asbestos exposure |
D. | A 58-year-old man with a 100-pack-year history of tobacco use with small-cell lung carcinoma |
E. | A 54-year-old woman who has never smoked with an adenocarcinoma |
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(D) | 2. |
一位58歲女性因腳上有一逐漸長大的黑痣而至皮膚科求診,黑痣最長直徑約9mm,邊緣不規則,病人自己發覺黑痣除了逐漸變大之外,顏色也漸加深變黑。切片檢查證實是黑色素瘤(melanoma),深度由皮膚表面一直延伸入真皮層(dermis)共深達0.5mm,計算每1mm之有絲分裂(mitosis)<1 (<1 mitosis/mm)。下列因素何者對病人黑色素瘤的預後(prognosis)的影響最大?
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A. | Anatomic site |
B. | Sex |
C. | Number of mitoses |
D. | Breslow Depth |
E. | Clark level |
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(E) | 3. |
一69歲男性,病理切片診斷確診罹患小細胞肺癌 (SCLC, small-cell lung cancer),PET/CT掃描結果顯示右側肺門(hilar)部位有一4 x 5公分腫塊,且同側有中等量(moderate)的肋膜積水,經肋膜積水穿刺檢查,肋膜積水細胞學證實同樣有SCLC癌細胞。下列敘述何者為真?
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A. | Surgical therapy alone has a high curative rate for his stage of SCLC |
B. | Radiation plays no palliative role at all in therapy for this disease |
C. | Twenty percent of patients with SCLC are diagnosed with the same stage of disease as this patient |
D. | The majority of patients with SCLC of this stage respond to chemotherapy alone and go into remission with a very high 3-year survival |
E. | This patient has extensive-stage disease |
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(E) | 4. |
下列危險因子,何者與食道鱗狀上皮細胞癌(squamous cell carcinoma)與食道腺癌(adenocarcinoma)均密切相關?
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A. | Male sex |
B. | Chronic gastroesophageal reflux disease |
C. | Barrett's esophagus |
D. | Lye ingestion |
E. | Cigarette smoking |
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(D) | 5. |
若針對「原發部位不明上皮癌」(CUP, carcinoma of unknown primary)的腫瘤檢體,進行次世代基因定序分析(NGS, next generation sequencing),最常見發生基因變異(GA, genetic alterations)的基因為下列何者?
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A. | KRAS |
B. | CDKN2A |
C. | ARID1A |
D. | TP53 |
E. | MTOR |
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(E) | 6. |
一位31歲男性,若有下列理學檢查發現或家族病史,會需要將「遺傳性非多發息肉性大腸癌」 (HNPCC,hereditary nonpolyposis colon cancer) 積極列入篩檢(screening)的考慮?
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A. | Innumerable polyps visualized on routine colonoscopy |
B. | Mucocutaneous pigmentation |
C. | New diagnosis of ulcerative colitis |
D. | (A)+(B)+(C) |
E. | Father, paternal uncle, and paternal cousin with colon cancer diagnosed at age 50, 66, and 35 years, respectively |
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(C) | 7. |
下列病人情形,何者與罹患頭頸部癌症(head and neck cancers)的風險增加,最無關連?
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A. | Alcohol consumption |
B. | Tobacco consumption |
C. | Helicobacter pylori infection |
D. | Epstein Barr virus infection |
E. | Human papillomavirus infection |
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(D) | 8. |
下列何者為最常見的惡性淋巴腫瘤 (lymphoid malignancy)?
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A. | Chronic lymphoid leukemia (CLL) |
B. | Acute lymphoid leukemia (ALL) |
C. | Hodgkin lymphoma (HD) |
D. | Non-Hodgkin lymphoma (NHL) |
E. | Multiple myeloma (MM) |
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(C) | 9. |
48歲女性病人,罹患第四期卵巢癌(ovarian cancer),接受6個療程carboplatin合併paclitaxel化學治療後,比較電腦斷層掃描前後的差異,如療效評估根據Response Evaluation Criteria in Solid Tumors (RECIST), 第1.1版(Ver. 1.1)的定義,若腫瘤治療後可測量的腫瘤「最長直徑」(longest diameters)的總和,共縮小了15%,且效果持續至少4週。可以評估她的卵巢癌對化學治療的"反應" (response)為何?
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A. | Complete response (CR) |
B. | Partial response (PR) |
C. | Stable disease (SD) |
D. | Progressive disease (PD) |
E. | 以上皆非 |
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(C) | 10. |
有關膽管癌(cholangiocarcinoma)的敘述,下列何者並不正確?
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A. | The incidence of cholangiocarcinoma has been increasing in recent years |
B. | Primary sclerosing cholangitis and hepatitis C virus infection are associated with cholangiocarcinoma |
C. | Most patients present due to an abnormal screening ultrasound, without symptoms |
D. | Asians infected with liver flukes have an increased risk of cholangiocarcinoma |
E. | Surgical resection may achieve 40% 5-year Survival with an R0 resection |
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