Analysis of Delayed Diagnosis in 324 Cases of Nasopharyngeal Carcinoma_West China Medical Journal

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Department of Oncology, Nuclear Industry 416 Hospital,Chengdu Sichuan 610051,China;

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Keywords：

鼻咽癌; 诊断; 延误诊断

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目的:探讨鼻咽癌延误诊断的原因。从而提高鼻咽癌患者的早期诊断率,改善治疗效果。方法: 回顾性分析324例在我科接诊前因各种因素而延误诊断的鼻咽癌患者首发症状、首诊误诊科室、误诊疾病。结果: 本组病例首发症状分别为颈部包块138例(42.5%)、鼻部症状148例(45.6%)、耳部症状66例(20.3%)、头痛46例(14.2%)、其他17例(5.2%),有两种首发症状的病例为91例。首诊误诊的疾病有颈部淋巴结炎、慢性鼻鼻窦炎、鼻出血、分泌性中耳炎、脑动脉硬化等27种疾病。涉及普外科、耳鼻咽喉科、神经内科、骨科、呼吸内科、口腔科、烧伤科、眼科、中医科等9个科室。结论: 加强鼻咽癌知识普及,完善继续医学教育及住院医师培训,积极寻找鼻咽癌的早期诊断方法能减少鼻咽癌的延误诊断。

Citation： KONG DEjun,FU Bo,WANG Ping,et al.. Analysis of Delayed Diagnosis in 324 Cases of Nasopharyngeal Carcinoma. West China Medical Journal, 2009, 24(9): 2248-2251. doi: Copy

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20.	王立侠,周纯武,连世东,等.鼻咽癌的MRI表现—— 附180例病例分析[J].中国医学影像技术,2006,22(6):854-857.
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1. Ministry of health of the people republic of China. Retrospective Sampling Survey on Malignant Tumor in China from 1990 to 1992.
2. LEONG JL,FONG KW,LOW WK．Factors contributing to delayed diagnosis in nasopharyngeal carcinoma[J]．J Laryngol Otol,1999,113(7):633-636.
3. MC Y U, J M. Epidemiology of nasopharyngeal carcinoma[J]. YuanSemin Cancer Biol. 2002,12(6): 421-429.
4. WW XIAO, F HAN, TX L U, et al.Treatment outcomes after radiotherapy alone for patients with earlystage nasopharyngeal carcinoma[J]. Int J Radiat Oncol Biol Phys,2009,74(4): 1070-1076.
5. 何艳梅,蔡巧玲,黄彩云,等.3028例鼻咽癌生存率统计[J].中国病案,2008,9(3): 38-39.
6. 易俊林,高黎,黄晓东,等.鼻咽癌的临床表现和预后[J].中国医学科学院学报,2006,28(3):315-317.
7. TEO PML, YU P, LEE WY, et al. Significant prognosticators after primary radiotherapy in 903 nondisseminated nasopharyngeal carcinoma evaluated by computer tomography[J]. Int J Radiat OncolBiol Phys,1996,36:291-304.
8. SPANO JP, BUSSON P, ATLAN D, et al. Nasopharyngeal carcinomas: an update[J]. Eur J Cancer,2003,39:2121-2135 .
9. 刘晖,葛晓峰,王春波.鼻咽癌首发症状的分析[J]. 黑龙江医学,2008,32(3):194-195.
10. 李明,秦日升,陈森.鼻咽癌颈部转移淋巴结针吸活检对预后的影响[J].宁夏医学,2007,2(2):306-307.
11. 王美江, 龚雪丽, 罗德红,等. 鼻咽癌颈淋巴结活检对预后的影响[J].遵义医学院学报,2006,2:157-158.
12. 魏国彪,张松, 张亚军,等. 鼻内镜下结合影像学资料对黏膜下型鼻咽癌活检的应用价值[J].临床耳鼻咽喉头颈外科杂志,2008,22(18),853-854.
13. SRIAMPORN S, VATANASAPT V, PISANI P, et al. Environmental risk factors for nasopharyngeal carcinoma: a casecontrol study in Northeastern Thailand[J].Cancer Epidemiol Biomarkers Prev,1992,1:345-348.
14. YIP KW, SHI W, PINTILIE M, et al.Prognostic significance of the EpsteinBarr virus, p53 Bcl2, and survivin in nasopharyngeal cancer[J].Clin Cancer Res, 2006, 12:5726-5732.
15. RICKINSON AB, KIEFF E. EpsteinBarr virus. In: Fields BN,Knipe DM, Howley PM, editors. Fields virology. 4th ed.Philadelphia (PA):LippincottRaven[M],2002:2575-2627.
16. ERI SETO,TADAMASA OOKA, JAAP MIDDELDORP,et al. Reconstitution of Nasopharyngeal CarcinomaType EBV Infection Induces Tumorigenicity[J].Cancer Res 2008,68(4):10301036.
17. WANLUN HSU, JENYANG CHEN, YINCHU CHIEN,et al.Independent Effect of EBV and Cigarette Smoking on Nasopharyngeal Carcinoma: A 20Year FollowUp Study on 9,622 Males without Family History in Taiwan[J]. Epidemiol Biomarkers Prev, 2009, 18: 1218-1226.
18. 唐国全,周向阳,阳茂春.EB病毒IgA滴度在鼻咽癌诊断的敏感性和特异性[J].广西医学, 2008,30(6):831-832.
19. 文玲,周艳宏, 肖岚,等. 鼻咽癌分子标志物研究术[J].生物化学与生物物理进展,2008,35(1):7-13.
20. 王立侠,周纯武,连世东,等.鼻咽癌的MRI表现—— 附180例病例分析[J].中国医学影像技术,2006,22(6):854-857.
21. D KING, AC VLANTIS, RKY TSANG, et al.Magnetic Resonance Imaging for the Detection of Nasopharyngeal[J].Carcinoma J Neuroradiol,2006,27: 1288 -1291.

West China Medical Journal

Analysis of Delayed Diagnosis in 324 Cases of Nasopharyngeal Carcinoma

Abstract Full text Figures/Tables Video References Cited by

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