食管上段癌临床误诊分析

Analysis of Misdiagnosis in Upper Esophageal Carcinoma

我院自1979年2月到1990年2月经内镜、病理或手术证实食管癌633例,其中上段癌174例(27.5％)。笔者着重分析其易被临床误诊的相关性,本组174例上段癌中,先前误诊为诸种疾病者71.2％(124/174例),其主要原因是偏信所获某些症状、体征或结果。并认为应结合临床综合判断,及时予以内镜或X线检查,方有助于上段癌的早期发现。

From February 1979 to February 1990,of 174 cases of upper esophagel carcinoma treated and confirmed by en- doscopy, surgery and pathology 124 cases (71.2%) were misdiagnosed clinically as chronic pharyngitis (74 cases, 42.5%), bleeding of upper digestive tract (24 cases, 13.8%), intercostal neuralgia (12 eases, 6.9%), neurosis (7 cas- es, 4.0%), vocal paralysis of unknown cause (4 cases, 2.3%), or coronary artery insufficiency (3 cases, 1.7%). The main cause of mistake was overconfidence in certain presenting symptoms or signs. It is concluded that taking as many evidences as the clinical, endoscopic and radiologic findings into consideration is important in making correct diagnosis of early upper esophageal carcinoma.