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本文收集1988年1月～1997年12月我院明确诊断的原发性肺癌826例,对其中因肺外表现为首发症状,而误诊的32例作一回顾性分析。报道如下。 1 临床资料 1.1 一般资料 本组病例中男25例,女7例,男:女为3.6:1。45岁以下的3例(6.7％),45岁以上的29例(93.3％),中位年龄56.4岁。既往有慢性支气管炎、肺气肿、肺结核等肺部病史者15例(46.9％),有吸烟史者22例(68.8％)。 1.2 确诊情况 32例肺痛全部经病理证实,其中痰找脱落细胞阳性者11例,纤支镜刷检加活检获得确诊9例,手术病理证实7例,锁骨上淋巴结活检证实者5例。 1.3 误诊时间 大部分患者确诊时已属于中晚期,初诊至确诊时间最短者25天,最长者28个月,平均9.5个月。 2 首发症状与误诊病种及分析
This article collected 826 cases of primary lung cancer diagnosed in our hospital from January 1988 to December 1997. We retrospectively analyzed 32 cases of misdiagnosis due to extrapulmonary manifestations. The report is as follows. 1 Clinical data 1.1 General information In this group of patients, 25 were males and 7 were females, males: females were 3.6:1. 3 patients below the age of 45 (6.7%), 29 patients over the age of 45 (93.3%), median Age 56.4 years old. In the past, 15 patients (46.9%) had chronic pulmonary bronchitis, emphysema, pulmonary tuberculosis, and 22 had a history of smoking (68.8%). 1.2 Confirmed diagnosis 32 cases of pulmonary pain were all confirmed by pathology. Among them, 11 cases were found to be positive for exfoliated cells. 9 cases were diagnosed by fibrobronchoscopy and biopsy, 7 cases were confirmed by surgical pathology, and 5 cases were confirmed by supraclavicular lymph node biopsy. 1.3 Misdiagnosis time Most patients have been diagnosed at the middle and late stage. The shortest time from the first consultation to the confirmed diagnosis is 25 days, and the longest is 28 months, with an average of 9.5 months. 2 first symptoms and misdiagnosis diseases and analysis