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; 診斷; 延誤診斷

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目的:探討鼻咽癌延誤診斷的原因。從而提高鼻咽癌患者的早期診斷率,改善治療效果。方法: 回顧性分析324例在我科接診前因各種因素而延誤診斷的鼻咽癌患者首發癥狀、首診誤診科室、誤診疾病。結果: 本組病例首發癥狀分別為頸部包塊138例(42.5%)、鼻部癥狀148例(45.6%)、耳部癥狀66例(20.3%)、頭痛46例(14.2%)、其他17例(5.2%),有兩種首發癥狀的病例為91例。首診誤診的疾病有頸部淋巴結炎、慢性鼻鼻竇炎、鼻出血、分泌性中耳炎、腦動脈硬化等27種疾病。涉及普外科、耳鼻咽喉科、神經內科、骨科、呼吸內科、口腔科、燒傷科、眼科、中醫科等9個科室。結論: 加強鼻咽癌知識普及,完善繼續醫學教育及住院醫師培訓,積極尋找鼻咽癌的早期診斷方法能減少鼻咽癌的延誤診斷。

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

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.	何艷梅,蔡巧玲,黃彩云,等.3028例鼻咽癌生存率統計[J].中國病案,2008,9(3): 38-39.
6.	易俊林,高黎,黃曉東,等.鼻咽癌的臨床表現和預后[J].中國醫學科學院學報,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.	劉暉,葛曉峰,王春波.鼻咽癌首發癥狀的分析[J]. 黑龍江醫學,2008,32(3):194-195.
10.	李明,秦日升,陳森.鼻咽癌頸部轉移淋巴結針吸活檢對預后的影響[J].寧夏醫學,2007,2(2):306-307.
11.	王美江, 龔雪麗, 羅德紅,等. 鼻咽癌頸淋巴結活檢對預后的影響[J].遵義醫學院學報,2006,2:157-158.
12.	魏國彪,張松, 張亞軍,等. 鼻內鏡下結合影像學資料對黏膜下型鼻咽癌活檢的應用價值[J].臨床耳鼻咽喉頭頸外科雜志,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.	唐國全,周向陽,陽茂春.EB病毒IgA滴度在鼻咽癌診斷的敏感性和特異性[J].廣西醫學, 2008,30(6):831-832.
19.	文玲,周艷宏, 肖嵐,等. 鼻咽癌分子標志物研究術[J].生物化學與生物物理進展,2008,35(1):7-13.
20.	王立俠,周純武,連世東,等.鼻咽癌的MRI表現—— 附180例病例分析[J].中國醫學影像技術,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.

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. 何艷梅,蔡巧玲,黃彩云,等.3028例鼻咽癌生存率統計[J].中國病案,2008,9(3): 38-39.
6. 易俊林,高黎,黃曉東,等.鼻咽癌的臨床表現和預后[J].中國醫學科學院學報,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. 劉暉,葛曉峰,王春波.鼻咽癌首發癥狀的分析[J]. 黑龍江醫學,2008,32(3):194-195.
10. 李明,秦日升,陳森.鼻咽癌頸部轉移淋巴結針吸活檢對預后的影響[J].寧夏醫學,2007,2(2):306-307.
11. 王美江, 龔雪麗, 羅德紅,等. 鼻咽癌頸淋巴結活檢對預后的影響[J].遵義醫學院學報,2006,2:157-158.
12. 魏國彪,張松, 張亞軍,等. 鼻內鏡下結合影像學資料對黏膜下型鼻咽癌活檢的應用價值[J].臨床耳鼻咽喉頭頸外科雜志,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. 唐國全,周向陽,陽茂春.EB病毒IgA滴度在鼻咽癌診斷的敏感性和特異性[J].廣西醫學, 2008,30(6):831-832.
19. 文玲,周艷宏, 肖嵐,等. 鼻咽癌分子標志物研究術[J].生物化學與生物物理進展,2008,35(1):7-13.
20. 王立俠,周純武,連世東,等.鼻咽癌的MRI表現—— 附180例病例分析[J].中國醫學影像技術,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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