原发性肺癌误诊分析——1000例总结

MISDIAGNOSTIC ANALYSIS AND EARLY DIAGNOSIS OFPRIMARY LUNG CANCER

本文总结了1000例肺癌的临床资料，分析了误诊原因。其中79.4％的肺病病人被误诊，早期误诊率高多发生在基层医院，主要与下列因素有关。1、肿瘤生物学特性，许多肺癌病例恶性程度大，转移早；早期症状轻微，不典型。本组有318例发现时已属晚期。2、医生经验不足警惕性不高，将180例肺癌误诊为肺部炎症，174例误诊为肺结核，109例误诊为慢性支气管炎。3、病人就诊延误，平均延误诊断时间4.7个月。在延误诊断时间半年以上的130例病人中，只有11例手术治疗。以上提示应对肺癌高危人群定期普查；在群众中加强防癌知识宣传教育，有病及早就医；需要加强基层医院的设备和技术力量，提高医生对肺癌的警惕性，减少误诊率。

We collected clinical details of 1000 patients with primary carcinoma of the lungs from October 1984 to May 1995 and analysed misdiagnostic causes, six hundrends and forty seven of 815 patients that showed diagnostic image were wrong. High misdiagnostic rate may be found often in local hospitals and mainly concerned with following factors.1. Biological characters of tumors:Pulmonary carcinoma in many patients was high maliglant and of metastasis. Symptoms were slight and/or atypical in the early stage. Three hundrends and eighteen patients found in our series were in late the stage. 2. The doctors' inexperience and/or not focusing their attention on lung cancer:Pulmonary carcinoma was misdiagnosted as pneumonia in 180 cases,as pulmonary tuberculosis in 174,as chronic bronchitis in 109 and so on. 3. Delay of diagnosis, The average time of delay was 4. 7 months. Merely 11 of 130 patients who were late over 6 months were treated by surgica procedure. It is suggested that the risk population for lung cancer should be regularly checked up,patients should go to see doctors as eraly as possible and instruments and doctor's skill in the local hospital should be developed.