摘要
目的探讨以非肿瘤转移性疼痛首发的青年肺癌的临床特点及误诊原因。方法回顾分析我院收治的3例青年肺癌误诊患者的临床资料。结果3例均为女性,1例以背痛为首发症状误诊为颈椎病,1例以胸痛为首发症状误诊为肋间神经痛,1例以胸痛为首发症状误诊为心绞痛、肺炎。3例误诊时间分别为1年、半年、3周,分别经胸腔穿刺活检、手术切除病理检查、CT引导下肺穿刺活检确诊为肺腺癌。1例行靶向治疗,目前正在靶向治疗中;2例给予手术切除联合术后化疗,目前正在化疗中。结论临床医生要提高对青年肺癌的警惕性,熟知其临床特点,拓宽诊断思维,遇到年轻患者出现难以解释的胸背痛症状或治疗效果不佳时,应及时完善胸部CT及肿瘤相关检查,从而避免或减少误诊。
ObjectiveTo investigate the clinical characteristics and misdiagnosis causes of lung cancer in young adults with non-metastatic pain as initial symptoms.MethodsThe clinical data of 3 young patients with lung cancer who were misdiagnosed in our hospital were retrospectively analyzed, and related literature was reviewed.ResultsAll the 3 cases were females, including 1 case with back pain as the initial symptom who was misdiagnosed as cervical spondylosis, 1 case with chest pain as the initial symptom who was misdiagnosed as intercostal neuralgia, 1 case with chest pain as the initial symptom who was misdiagnosed as angina pectoris and pneumonia.The duration of misdiagnosis of 3 cases was 1 year, 6 months and 3 weeks, respectively.They were diagnosed as lung adenocarcinoma by thoracic puncture biopsy, surgical excision and pathological examination, and CT-guided lung puncture biopsy.One patient had been receiving targeted therapy, and 2 patients received surgical resection combined with postoperative chemotherapy and was undergoing chemotherapy.ConclusionClinicians should enhance their vigilance against lung cancer in young people, be familiar with its clinical characteristics, and broaden clinical thinking.When young patients have unexplained symptoms of chest or back pain or poor treatment effect, they should timely receive chest CT and tumor-elated examination, so as to avoid or reduce misdiagnosis.
作者
熊鑫
吴文杰
何彦侠
赵惠敏
薛兵
XIONG Xin;WU Wen-jie;HE Yan-xia;ZHAO Hui-min;XUE Bing(Department of Respiratory Medicine,Chuiyangliu Hospital of Beijing,BeiJing 100022,China)
出处
《临床误诊误治》
2019年第10期10-14,共5页
Clinical Misdiagnosis & Mistherapy
关键词
肺肿瘤
青年人
误诊
颈椎病
心绞痛
Lung neoplasms
Young adult
Misdiagnosis
Cervical spondylosis
Angina pectoris
