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目的认识以肺外表现为首发症状的肺癌是早期肺癌的表现,预防早期肺癌的误诊和漏诊,对肺外表现为首发症状的肺癌进行临床分析。方法我院2000年1月-2008年1月住院的873例肺癌患者中,39例是肺外表现为首发症状的肺癌,分析肺外表现症状与肺癌的病理分型之间的联系。结果有肺外表现为首发症状39例,其中杵状指最常见,为41.0%,内分泌异位综合征为33.3%,神经副癌综合征为25.6%,肥大性肺性骨关节病为12.8%,下肢血栓性静脉炎为10.3%,肺栓塞2例,全身紫癜2例。结论具有肺外表现为首发症状的肺癌,起病隐匿,临床表现复杂,患者缺乏呼吸道症状和体征或者肺外表现出现在呼吸道症状之前,约(37/39)94.9%的具有副癌综合征的早期肺癌被误诊。因此,对有上述综合征的患者应进一步查找有无隐匿性肺癌病灶,减少误诊误治。
OBJECTIVE: To know that lung cancer with extrapulmonary manifestations as the first symptom is the manifestation of early lung cancer, to prevent the misdiagnosis and missed diagnosis of early lung cancer, and to analyze the clinical manifestations of lung cancer which is the first symptom of extrapulmonary lung cancer. Methods Among 873 lung cancer patients hospitalized in our hospital from January 2000 to January 2008, 39 cases were lung cancer with extra pulmonary appearance as the first symptom, and the relationship between extrapulmonary symptoms and pathological type of lung cancer was analyzed. The results showed pulmonary extravasation of the first symptom in 39 cases, of which clubbing finger is the most common, 41.0%, 33.3% of the endocrine heterotopic syndrome, para-cancer syndrome was 25.6%, hypertrophic pulmonary osteoarthrosis was 12.8% , Lower extremity thrombophlebitis was 10.3%, pulmonary embolism in 2 cases, 2 cases of systemic purpura. Conclusions Lung cancer with extrapulmonary manifestations as the first symptom, occult onset, complicated clinical manifestations, lack of respiratory symptoms and signs in patients, or pulmonary manifestations of respiratory symptoms, were found to be (37/39) 94.9% of patients with paraneoplastic syndrome Early lung cancer is misdiagnosed. Therefore, patients with the above syndrome should be further identified with or without occult lung cancer lesions to reduce misdiagnosis and mistreatment.