214例结直肠癌误诊原因分析

目的:回顾性分析了214例结直肠癌的误诊原因,以期进一步提高早期诊断率。方法:患者就诊3次以上未能确诊为结直肠癌时定为误诊病例。18年间共确诊结直肠癌1 802例,误诊214例。误诊时间最长达3年,最短为1个月。结果:误诊率为11.9%(214/1 802)。易误诊为内痔及肛周炎、急慢性肠炎、急慢性痢疾、急慢性阑尾炎、直肠息肉、肠梗阻、慢性结肠血吸虫病、肠痉挛及肠外病变(缺铁性贫血、胆囊炎、胆石症、溃疡病、卵巢囊肿等)。结论:对有肠道症状的患者,按良性疾病治疗效果不佳时,应想到有结直肠癌的可能,及时行肿瘤标志物及结肠镜检查,可提高结直肠癌的早期诊断率。

Analysis of Reasons in 214 Cases of Misdiagnosed Colorectal Cancer

Objective: To study retrospectively the misdiagnostic reasons in 214 cases of colorectal cancer in order to increase diagnostic rate at early phase.Methods: The cases which could not be diagnosed as colorectal cancer accurately more than three times were defined as misdiagnosed cases.A total of 1 802 cases were diagnosed definitely as colorectal cancer in the past eighteen years,and 214 cases were misdiagnosed.The longest time of misdiagnosis was three years,and the shortest time was one month.Results: The misdiagnostic rate was 11.9%(214/1 802).The misdiagnosed cases were internal hemorrhoids or anusitis,acute or chronic enteritis,acute or chronic dysentery,(acute) or chronic appendicitis,rectal polyp,intestinal obstruction,chronic colonic schistosomiasis,intestinal spasm and external intestinal diseases(such as iron-deficiency anaemia,cholecystitis,cholelithiasis,ulcer,ovary cyst,etc.).Conclusion: The diagnosis of colorectal cancer should be taken in consideration when the conventional treatment had no effect on the patients with intestinal symptoms.The diagnostic rate of colorectal cancer could be raised at early phase by combining detection of tumor symbolic markers and examination of endoscope.