原发性支气管癌误诊为呼吸系统结核病45例分析

Analysis of 45 cases with primary bronchial carcinoma misdiagnosed as respiratory tuberculosis

目的分析45例原发性支气管癌误诊为呼吸系统结核病的原因、诊断及预后。方法统计分析我院2013年1月~2014年9月收治的45例被误诊为原发性支气管癌患者的临床资料。结果 105例肺癌患者,5例患者为肺结核合并肺癌,其余100例患者中被误诊为原发性支气管癌45例,达到了45%的误诊率;在误诊疾病类型方面,34例被误诊为肺结核,10例患者被误诊为结核性胸膜炎,1例患者被误诊为肺结核合并胸膜炎;45例患者主要采用纤维支气管镜检查活检病理、螺旋CT和高分辨率CT诊断,分别占总数的22.2%和20.0%。3个月和1年死亡率分别为8.9%和24.4%。结论原发性支气管癌具有较高的误诊率,极易被误诊为肺结核,该类患者具有较高的1年死亡率,纤维支气管镜检查活检病理、螺旋CT和高分辨率CT是主要诊断方法。

Objective To analyze causes,diagnosis and prognosis of 45 cases with primary bronchial carcinoma misdiagnosed as tuberculosis respiratory system. Methods The clinical data of 45 cases of patients treated in our hospital and misdiagnosed as primary lung cancer from January 2013 to September 2014 were statistically analyzed. Results Among the 105 cases of lung cancer patients,5 cases were pulmonary tuberculosis with lung cancer,and the remaining 100 cases were misdiagnosed as primary lung cancer,45 cases,reaching 45% misdiagnosis rate;in terms of the type of disease misdiagnosed,34 cases were misdiagnosed as tuberculosis,10 patients were misdiagnosed as tuberculous pleurisy,1 case was misdiagnosed as tuberculosis pleurisy merger;45 cases mainly received bronchoscopy biopsy,spiral CT and high-resolution CT diagnosis,respectively,accounting for 22.2% and 20.0% of the total.The three-month and 1-year mortality rates were 8.9% and 24.4%. Conclusion Primary lung cancer has a high rate of misdiagnosis can easily be misdiagnosed as tuberculosis,these patients have a higher 1-year mortality,bronchoscopy biopsy,spiral CT and high-resolution CT is the primary diagnostic method.