鼻咽癌的临床表现及误诊(附507例分析)

An analysis of clinical presentation and misdiagnosis in patient with nasopharyngeal carcinoma

目的：分析507例鼻咽癌的临床表现和误诊特点。方法：收集自1996年1月至1999年12月我科收治的经病理确诊的507例鼻咽癌患者病史资料，分析其临床表现及误诊率。结果：本组鼻咽癌病例的主要临床表现包括涕血，鼻塞，耳鸣，听力下降，头痛，颈淋巴结肿大，颅神经损害和Horner's征。首诊时的误诊率为86.98％。对生活影响较小的症状如涕血、鼻塞、耳鸣误诊时间较长，头痛、颈淋巴结肿大和颅神经等表现严重的症状误诊时间较短。结论：本文结果表明对具有上述鼻咽癌症状的病人进行仔细的耳鼻喉科检查是及时诊断鼻咽癌的重要步骤。

Objective: To investigate the clinical presentation and misdiagnostic causes of 507 patients with nasopharyngeal carcinoma. Methods: The analysis was performed in 507 cases of the nasopharyngeal carcinoma treated from January 1996 to the end of 1999. Results: The clinical presentation of patients with nasopharyngeal carcinoma includes epistaxis, nasal obstruction, ear pain, hearing loss, headache, cervical lymph node involvement, cranial nerve involvement and horner's syndrome. At the time of initial diagnosis, the rate of misdiagnosis was 86.98% for all cases. The duration before getting pathologic document was longer in patient with mild symptoms such as epistaxis, nasal obstruction and/or ear pain than that with headache, cranial involvement and/or cervical lymph node involvement. Conclusion: Our results demonstrate that it is an important procedure for patients with symptoms linking to nasopharyngeal carcinoma to receive careful examination for the ear, nasopharynx and nose.