胰腺癌误诊因素分析

ANALYSIS OF MISDIAGNOSTIC FACTORS OF PANCREATIC CANCER

为探讨胰腺癌误诊比例、病种和原因 ,以及误诊对胰腺癌诊治的影响 ,给避免误诊误治提供参考 ,回顾性分析研究 10 2 7例确诊的胰腺癌患者的误诊情况 ,同时将所有患者区分为误诊组与非误诊组 ,对各有关资料进行统计学处理 ,比较两组的差异性。结果显示 ,10 2 7例患者 5 86例曾被误诊 (5 7 1% )。误诊病种 5 5种 ,最常见的为胃十二指肠炎、消化性溃疡、病毒性肝炎、胆囊炎胆石症及慢性胰腺炎。误诊组与非误诊组的确诊时间、主要症状、根治切除率、半年存活率均有显著差异 (P <0 0 5 )。提示胰腺癌极易误诊 ,早期诊断和及时治疗对疾病预后有重要意义。临床医师应认识其各种症状 ,尽可能系统检查 ,综合分析 。

This study was aimed to assess the proportion and causes of misdiagnosis of pancreatic cancer (PC), and the effects of misdiagnosis on and treatment of PC, so as to sum up experiences and improve the diagnosis and treatment. 1027 cases with confirmed diagnosis of PC were retrospectively analyzed in detail. The patients were divided into misdiagnosed group and a group with correct diagnosis. The relevant data of the two groups were analyzed by stastical methods, and the differences between them were assessed. It was found that 586 cases (57 1%) were misdiagnosed.Fifty five diseases were involved in misdiagnosis, among them gastritis and duodenitis, peptic ulcer, virus hepatitis, cholecystitis and cholelithiasis, chronic pancreatitis wese the commonest. The differences of duration of diagnosis, main symptoms, resection rate, and half year survival rate between misdiagnosed group and correct diagnosis group were significant. It is concluded that PC is often misdiagnosed as other diseases. Early diagnosis and treatment is critical to the prognosis. The physician should be aware that PC may present a veriety of clinical manifestations, and therefore he or she should analyze comprehensively the symptoms and signs in order to improve diagnosis and treatment.