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为了探讨肺癌诊断延迟的原因,回顾性分析86例晚期肺癌患者诊断延迟的原因,包括69例非小细胞肺癌和17例小细胞肺癌。结果:患者中位诊断延迟时间为8.2周(1.7～83.0周),其中患者延迟时间为4周(0～78周),医生延迟时间为1.3周(0.3～52.3周)。29.1%(25/86)的患者首诊时被误诊,这类患者的医生延迟时间为13.6周(3.9～52.3周),而首诊时怀疑为肺癌患者的医生延迟时间为1.1周(0.3～5周),明显较短,P<0.001。以肺外表现为首发症状的患者,误诊率高达62.5%(5/8)。初步研究结果提示,晚期肺癌的诊断延迟原因较复杂,既有患者的因素也有医生的因素,有必要对两种情况进行前瞻性研究。
To investigate the causes of delayed diagnosis of lung cancer, the causes of delayed diagnosis in 86 patients with advanced lung cancer were retrospectively analyzed, including 69 non-small cell lung cancer and 17 small cell lung cancer. Results: The median time to diagnosis was 8.2 weeks (range, 1.7 to 83.0 weeks). The patients had a delay of 4 weeks (range, 0 to 78 weeks) and a doctor’s delay of 1.3 weeks (range, 0.3 to 52.3 weeks). 29.1% (25/86) of the patients were misdiagnosed at the first visit. The delay time of the doctors in these patients was 13.6 weeks (3.9-52.3 weeks), while the delay of doctors who were suspected to be lung cancer patients at the first visit was 1.1 weeks (0.3 ~ 5 weeks), significantly shorter, P <0.001. Patients who presented with extrapulmonary symptoms as the first symptom had a misdiagnosis rate of 62.5% (5/8). Preliminary findings suggest that the late diagnosis of delayed diagnosis of advanced lung cancer is more complicated, both patients and doctors have the factor, it is necessary to prospective study of two cases.