原发性肝癌51例误诊分析

目的：分析原发性肝癌（HCC）误诊原因，增强HCC肝外表现的认识，提高HCC早期诊断水平。方法：回顾性分析51例误诊HCC临床资料。结果：误诊率19．4％（51／263）；误诊病种为慢性肝炎、肝硬化、肝脓肿、胆囊炎、胆石症、急性梗阻性化脓性胆管炎、肝血管瘤、脑血管意外、美尼尔氏病、急腹症、消化性溃疡、胃肠炎、骨关节疾病、肺部感染肺癌、胸膜炎等。结论：HCC早期缺乏特异性表现，中晚期临床表现多样化，容易误诊；重视HCC特殊临床表现与转移灶症状，全面细致查体，动态观察实验室检查与影像学资料，可以减少误诊。

Analysis on Misdiagnosis of 51 Cases of Primary Hepatic Carcinoma

Objective: To identify the reasons for misdiagnosis of primary hepatic carcinoma(PHC) in order to promote its diagnosis.Methods: 51 misdiagnosed PHC cases were analyzed retrospectively.Results: The misdiagnosis rate of PHC was 19.4%(51/263).The misdiagnosed cases included chronic hepatitis,hepatic cirrhosis,liver abscess,cholecystitis,gall-bladder stone,acute obstructive suppurative cholangitis,liver hemangioma,Meniere's disease,acute abdomen,peptic ulcer,gastroenteritis,joint diseases,pulmonary infections,lung cancer and pleuritis,etc.Conclusion: No specific manifestation at early stage and diversified features mid-late stage of HPC cause misdiagnosis.For the purpose of decreasing misdiagnosis rate of HPC,clinicians should pay attention to the special and metastatic signs of HPC,overall physical examination and continuous laboratory and imaging examinations to lessen the occurrence of misdiagnosis.