结肠癌49例误诊分析  

Misdiagnosis analysis of colon cancer in 49 cases

作　　者：莫乃榕[1] 陈华锋[1] 哈晓冬 吴登东 沓世念[1] 邵少尉 

机构地区：[1]广东省肇庆市第二人民医院普外科,肇庆526060

出　　处：《临床医学》2013年第4期104-105,共2页Clinical Medicine

摘　　要：目的探讨结肠癌的误诊原因及预防方法。方法回顾性分析2007年1月至2012年11月肇庆市第二人民医院普外科收治的218例结肠癌中存在误诊的49例患者的资料。结果 49例结肠癌在结肠镜检查或手术明确诊断前存在误诊。误诊为慢性结肠炎21例,盆腔炎12例,痔疮8例,胃炎及缺铁性贫血5例,结肠息肉4例,慢性阑尾炎2例,肠梗阻1例。其中4例患者存在二次误诊。病理类型:管状腺癌18例,乳头状腺癌17例,黏液腺癌13例,未分化癌1例。按Dukes分期,无A期病例,B期10例,C期35例,D期4例。结论对有大便习惯与粪便性状改变、内科治疗效果不佳的患者要考虑结肠癌的可能,尽早行结肠镜检查,而检查阴性但临床上仍怀疑的患者应重复检查,避免漏诊。Objective To investigate the misdiagnosis reasons and prevention methods of colon cancer.Methods The data of 49 patients who were misdiagnosed in 218 cases of colon cancer from January 2007 to November 2012 in the second people’s hospital of Zhaoqing were retrospectively analyzed.Results Forty-nine cases of colon cancer were misdiagnosed before colonoscopy or surgical diagnosis.Twenty-one cases were misdiagnosed as carcinoma of colon,12 cases were misdiagnosed as pelvic inflammation,8 cases were misdiagnosed as piles,5 cases were misdiagnosed as gastritis merger iron deficiency anemia,4 cases were misdiagnosed as colon polyps,2 cases were chronic appendicitis and 1 case was diagnosed as ileus.Four patients existed secondary misdiagnosis.Of the 49 cases,18 cases were tubular adenocarcinoma,17 cases were papillary adenocarcinoma,13 cases were mucous adenocarcinoma and 1 case was anaplastic carcinoma.According to the Dukes staging,there was none of stage A,10 cases of stage B,35 cases of stage C,4 cases of stage D.Conclusion The patients who have a change of the habits and characteristic in feces and the medical treatment has no effect may be suffered from colon cancer,and examined by colonoscopy as soon as possible.For the patients with clinically suspected colon cancer,while having negative colonoscopy result,the diagnosis should not be easily precluded and take the repeated examination to avoid missed diagnosis.

关 键 词：结肠癌 误诊 预防 

分 类 号：R735.35[医药卫生—肿瘤]