诊断学理论与实践Issue(4)：383-387,5.DOI:10.3969/j.issn.1671-2870.2014.04.008
2013年上海嘉定地区胃镜筛查胃癌漏诊的临床研究
A clinical study of missed gastric cancer during routine upper GI endoscopy in Jiading District of Shanghai in 2013
吴云林 1李佑 2项明 2毛峻岭 3吴巍 4黄天生 5陆敏 6陈晓敏 7罗方秀 8陆亭伟 8袁晓琴1
作者信息
- 1. 上海交通大学医学院附属瑞金医院北院 消化内科
- 2. 上海交通大学医学院附属瑞金医院北院外科，上海 201821
- 3. 上海市嘉定区中心医院消化内科，上海 201800
- 4. 上海交通大学医学院附属瑞金医院消化内科，上海 200025
- 5. 上海市嘉定区中医医院消化内科，上海 201800
- 6. 上海市嘉定区南翔医院消化内科，上海 201802
- 7. 上海市嘉定区安亭医院消化内科，上海 201805
- 8. 上海交通大学医学院附属瑞金医院北院病理科
- 折叠
摘要
Abstract
Objective: To investigate the missed gastric cancer during endoscopic examinations (24 837) in 5 hospi-tals in Jiading district of Shanghai in 2013. Methods: Repeated upper GI endoscopy was performed by qualified endo-scopists and multiple biopsies were performed. The patients suspected of having gastric cancer underwent surgical opera-tion or endoscopic excision, and those who met the criteria of missed diagnosis were studied and potential causes and medical history within 1 year were analyzed. Results: A total of 297 cases (1.2%) of gastric cancer were diagnosed by biopsy pathology. Ninety-nine patients received surgery in local Jiading district hospitals. Surgical pathology demonstrated 11 cases of early gastric cancer (11.1%), 87 cases of advanced gastric cancer (87.9%) and 1 mucosa-associated lymphoid tissue (MALT) lymphoma (1.0%). Eight patients met the criteria of missed diagnosis. These 8 patients received an average of 3.5 sessions of upper GI endoscopy prior to diagnosis, with the previous endoscopic diagnosis of either chronic gastritis or concurrent with intestinal metaplasia. The mean interval between initial consultation and pathologic confirmation of gastric malignancy was 12.5 months. The 8 missed cases were surgically proved, including 4 early gastric cancer without lymph node metastasis (50%), 3 advanced cancer (37.5%) and 1 MALT lymphoma (12.5%). Conclusions: Eight cases (8.1%) are missed in a total of 99 surgically treated gastric cancer patients. The situation of missed gastric cancer is ana-lyzed. Potential causes included the absence of marked lesion, missed judgment of malignancy as benign diseases, and a false negative biopsy. Lack of tumor recognition ability during routine endoscopy screening is the crucial.关键词
内镜检查/胃癌漏诊/误诊Key words
Endoscopy/Gastric cancer/Missed diagnosis分类
医药卫生引用本文复制引用
吴云林,李佑,项明,毛峻岭,吴巍,黄天生,陆敏,陈晓敏,罗方秀,陆亭伟,袁晓琴..2013年上海嘉定地区胃镜筛查胃癌漏诊的临床研究[J].诊断学理论与实践,2014,(4):383-387,5.
