误诊疾病数据库2005—2012年单病种误诊文献研究:乳腺癌

Research on 2005—2012 Single Disease Misdiagnosis Document of Misdiagnosed Disease Database: Breast Cancer

乳腺癌是全球范围内女性最常见的恶性肿瘤之一,也是引起女性死亡的重要病因。本文分析中国误诊疾病数据库收录2005—2012年发表在中文医学期刊的乳腺癌误诊文献共66篇,总误诊例数757例,其中涉及误诊率的文献21篇,病例总数为1804例,误诊病例337例,误诊率18.68%;其他误诊文献45篇,误诊病例420例。共误诊为19种疾病,部分病例先后误诊为多种疾病,误诊疾病居前4位的依次为乳腺增生、乳腺纤维腺瘤、乳腺炎、乳腺良性肿瘤。误诊原因分析中以经验不足、缺乏对该病的认识最多,占37.23%;其次为未选择特异性检查项目及影像学诊断原因,各占21.17%。误诊后果均为Ⅱ级,即因误诊造成病情迁延。提示临床医师应提高对乳腺癌的认识,重视问诊及查体,并及时选择合适的医技检查如B超、钼靶X线、乳腺MRI等,必要时行病理检查,以尽早明确诊断并治疗。

Breast cancer is one of the most common malignant tumors worldwide,and is an important cause of death in women. This paper analyzes 66 misdiagnosis references of breast cancer published in Chinese medical journals,which are included in China＇s misdiagnosed disease database from 2005 to 2012. The total misdiagnosed cases are 757,including 21 references involving the misdiagnosis rate,with a total of 1804 cases,including 337 cases of misdiagnosed cases with a misdiagnosis rate of 18. 68%; there are other 45 misdiagnosis papers including 420 cases of misdiagnosed cases. Some cases are misdiagnosed as 19 kinds of diseases,on top of which in order are mammary gland hyperplasia,breast fibroadenoma,mastitis,and breast benign tumor. Misdiagnosis analysis shows that the cause of misdiagnosis is insufficient experience and lack of understanding of the disease,accounting for 37. 23%,followed by not choosing specific inspection items and imaging diagnosis cause,each accounting for 21. 17%. The misdiagnosis consequences are all Ⅱ level; that is misdiagnosis can cause longer course of the disease. It is suggested that clinicians should raise awareness of breast cancer and pay attention to health education,attach great importance to the interrogation and examination,and as quickly as possible choose the appropriate medical examination,such as ultrasound,molybdenum target X-ray,breast MRI,etc. If necessary,pathologic examination should be performed for early diagnosis and treatment.