Causes Analysis of Missed Diagnosis and Misdiagnosis for Lung Cancer

WEI Xi-cui; WANG Hui-xia

doi:10.3969/j.issn.1002-3429.2017.02.004

Abstract：Objective To investigate causes and prevention methods of missed diagnosis and misdiagnosis for lung cancer. Methods Clinical data of 15 missed diagnosis or misdiagnosis patients with lung cancer admitted during January 2015 and May 2016 was retrospectively analyzed. Results All the 15 patients were primarily diagnosed in our hospital, of whom 1 patient was misdiagnosed as having cor pulmonale combined with syndrome of inappropriate antidiuretic hormone ( ADH) , 5 patients were misdiagnosed as having tuberculosis, 3 patients as having chronic cholecystitis, 4 patients as having bronchitis, and 4 patients were diagnosed as having chronic obstructive pulmonary disease ( COPD) in acute episode, and lung cancer was missed diagnosis in 2 patients. The average time of missed diagnosis and misdiagnosis was 7 d-3 months. Lung cancer was confirmed by pathologic examination of fiexible bronchofiberscope in 5 patients and by cytological examination of pleural effusion in 5 patients;other 3 patients were diagnosed as having lung cancer by thoracic CT examination, and were confirmed by pathological results after elective surgery;lung cancer was confirmed by pathologic examination of lung biopsy. Pathological results were 5 patients with squamous cell carcinoma, 5 patients with adenocarcinoma and 5 patients with small cell lung cancer. After confirming diagnosis, 12 patients underwent surgery, and 2 patients received chemotherapy, and 1 pa-tient received expectant treatment;14 patients were discharged after conditions improved by appropriate treatment, 1 patient died after treatment failure. Conclusion Clinicians should improve knowledge of clinical features and X-ray imaging findings of lung cancer. Clinician should pay more attention for patients with similar symptoms, carefully ask medical history, compre-hensively give examinations and analyze condition changes so as to eliminate or confirm lung cancer as soon as possible, and then missed diagnosis and misdiagnosis rate can be decreased.