原发性支气管肺癌误诊原因及早期诊断分析

Analysis of misdiagnostic causes and the early diagnosis in patients with primary bronchogenic carcinoma

目的探讨原发性支气管肺癌的早期诊断。方法对256例经病理学证实的原发性支气管肺癌进行回顾性分析。结果本组256例中误诊118例,占46.09%,总误诊时间7.72个月。误诊依次为肺结核、肺炎和慢性支气管病变等20种以上疾病。期患者仅占7.81%,～期达75.39%,根治性手术仅占10.15%,预后较差。结论肺癌的早期诊断有一定难度,建立二级预防体系,对高危人群常规定期进行包括痰、影像学或纤支镜检查以发现早期患者具有重要价值。

Objective:To investigate the early diagnosis of primary bronchogenic carcinoma (PBC).Methods:256 cases of PBC which were confirmed by pathalogy were analyzed retrospectively.Results:118 cases were misdiagnosed(46.09%).The total misdiagnostic interval associated with the patients and medical factors was 7.72 months in the series. There were over 20 kinds of diagnosis in order of tuberculosis,pneumonia and chronic bronchi lesions,etc.The patients who were in stage Ⅰtumor took only 7.81%, while stage Ⅲ and Ⅳ took 75.39%,eradicative operating rate was 10.15%. The prognosis was very poor.Conclusion:Because the early diagnosis of PBC was very difficult,two level preventive systems should be set up.It is the most important to check the high risk persons periodically, including spatum,imaging or bronchoendoscopy to make the early diagnosis of PBC.