晚期肺癌患者诊断延迟的原因分析

Analysis of delay in diagnosis of advanced lung cancer

为了探讨肺癌诊断延迟的原因,回顾性分析86例晚期肺癌患者诊断延迟的原因,包括69例非小细胞肺癌和17例小细胞肺癌。结果:患者中位诊断延迟时间为8.2周(1.7～83.0周),其中患者延迟时间为4周(0～78周),医生延迟时间为1.3周(0.3～52.3周)。29.1%(25/86)的患者首诊时被误诊,这类患者的医生延迟时间为13.6周(3.9～52.3周),而首诊时怀疑为肺癌患者的医生延迟时间为1.1周(0.3～5周),明显较短,P<0.001。以肺外表现为首发症状的患者,误诊率高达62.5%(5/8)。初步研究结果提示,晚期肺癌的诊断延迟原因较复杂,既有患者的因素也有医生的因素,有必要对两种情况进行前瞻性研究。

The objective of this study was to explore the delay in diagnosis of patients with advanced lung cancer. The di agnostic delay in 86 patients with advanced lung cancer was analyzed retrospectively, which included 69 patients with non-small cell lung cancer and 17 patients with small cell lung cancer. The overall median diagnostic delay was 8.2 w （1.7-83.0 w）, and patient＇s delay was 4 w （0-78 w）, doctor＇s delay was 1.3 w （0. 3--52. 3 w）. A total of 29.1%（25/86） patients who were misdiagnosed had longer doctors delay of 1.3 w （0. 3 52.3 w） ,P%0. 001, and than the patients who were suspected for lung cancer, whose doctors delay were 1. lw（0. 3-5 w）. The misdiagnosis rate in patients with extrapulmonary presentations as first symptom was 62. 5%（5/8）. In conclusion, the reasons of diagnosis delay in advanced lung cancer was complicated. Patients and doctors should all take responsibility for diagnostic delay in patients with lung cancer. It is necessary to conduct perspective study for these conditions.