[{"data":1,"prerenderedAt":64},["ShallowReactive",2],{"q-nurse-111-1-basic-medicine-044":3},{"subject":4,"subjectSlug":5,"subjectFullName":6,"question":7,"related":35,"lastmod":63},"基礎醫學","basic-medicine","基礎醫學(包括解剖學、生理學、病理學、藥理學、微生物學與免疫學)",{"id":8,"webId":9,"year":10,"session":11,"subject":4,"number":12,"stem":13,"options":14,"answer":19,"answerNote":20,"images":21,"explanation":22,"explanationDeep":23,"topics":24,"freq":27},"nurse-111-1-基礎醫學-044","nurse-111-1-basic-medicine-044",111,1,44,"下列那一項因素與波雷特氏食道（Barrett esophagus）發生腺癌（adenocarcinoma）最有關係？",{"A":15,"B":16,"C":17,"D":18},"上皮細胞的異生程度","波雷特氏食道的長短","波雷特氏食道的發炎程度","有無食道狹窄發生","A",null,[],"本題考點為波雷特氏食道（Barrett esophagus）進展為腺癌的最關鍵風險預測因子。Barrett 食道是長期胃食道逆流造成食道下段鱗狀上皮化生為柱狀上皮，其癌變是循「化生→異生（dysplasia）→腺癌」的順序演進，因此上皮細胞的異生程度（尤其高度異生 high-grade dysplasia）最能預測腺癌風險，選 A。波雷特食道的長短（B）雖與風險有些關聯但非最直接的決定因子。發炎程度（C）是背景刺激因素，而非癌變的直接病理指標。有無食道狹窄（D）反映的是逆流併發症與纖維化，與腺癌發生無直接因果。故追蹤 Barrett 食道以定期切片評估異生程度為核心。","病生理主軸：GERD 慢性酸與膽汁逆流 → 腸上皮化生（含杯狀細胞的柱狀上皮）→ 低度異生 → 高度異生 → 腺癌。臨床監測策略正是依 dysplasia 分級決定內視鏡追蹤頻率或介入（如射頻燒灼、內視鏡黏膜切除）。記憶口訣：「看癌變風險，看 dysplasia」。長度（long-segment vs short-segment）為次要風險修飾因子，狹窄、潰瘍屬併發症表現，皆非癌變的直接分子病理指標。",[25,28,31,33],{"term":26,"count":27},"腸上皮化生",3,{"term":29,"count":30},"波雷特氏食道",2,{"term":32,"count":11},"異生(dysplasia)",{"term":34,"count":11},"腺癌演進",[36,40,45,49,53,58],{"webId":37,"stem":38,"number":39,"year":10,"session":11},"nurse-111-1-basic-medicine-045","下列何者與新生兒呼吸窘迫症候群最不相關？",45,{"webId":41,"stem":42,"number":43,"year":44,"session":11},"nurse-112-1-basic-medicine-011","下列何者屬於胜肽類神經傳導物質？",11,112,{"webId":46,"stem":47,"number":48,"year":44,"session":27},"nurse-112-3-basic-medicine-005","下列血管何者與下腔靜脈（inferior vena cava）直接相連？",5,{"webId":50,"stem":51,"number":27,"year":52,"session":11},"nurse-114-1-basic-medicine-003","下列何者會導致電位過極化（hyperpolarizing），進而誘發抑制性突觸後電位（inhibitory postsynaptic potential, IPSP）的表現？",114,{"webId":54,"stem":55,"number":56,"year":57,"session":30},"nurse-115-2-basic-medicine-007","男性的精子（sperm）主要在何處儲存並且發育成熟（mature）？",7,115,{"webId":59,"stem":60,"number":61,"year":62,"session":30},"nurse-106-2-basic-medicine-071","下列何者不是腸內桿菌的抗原？",71,106,"2026-09-04",1788510733068]