肺癌临床误诊原因分析OA

Objective To analyze the causes of misdiagnosis and preventive measures of lung cancer.Methods The clin-ical data of 2 patients with previously misdiagnosed lung cancer admitted to our hospital from January to December 2024 were retro-spectively analyzed.Results One patient was admitted due to cough,hot flashes and night sweats for more than 4 months,and was initially diagnosed as tuberculous pleurisy by chest CT examination and treated with anti-tuberculosis drugs.The patient's symptoms worsened.According to the head,chest and abdomen CT,tumor marker examination,and pleural effusion,the possibility of lung cancer with multiple metastases was considered.CT-guided puncture of the right lung was performed,and the pathological examina-tion showed adenocarcinoma of the right lung.The clinical diagnosis was lung cancer with bilateral lung metastasis and bone metas-tasis.The misdiagnosis lasted 4.5 months.The patient was discharged after chemotherapy,targeted therapy,thoracic puncture drainage,symptomatic support and other treatments.The patient was relieved after 6 cycles of chemotherapy.Chest CT was per-formed in one patient because of cough and expectoration without blood in sputum or fever,and the increased serum carcinoembry-onic antigen was detected.The initial diagnosis was community-acquired pneumonia,and the symptoms were relieved after antibiotic treatment.Three months afterwards,the patient developed dull pain in the left chest and back.Reexamination of CT showed a cen-tral mass in the left lung and elevated carcinoembryonic antigen.The diagnosis of small cell lung cancer in the left lung was con-firmed by CT-guided biopsy.The misdiagnosis lasted 3.5 months.After diagnosis,chemotherapy was given,and the disease was controlled without new lesions.Conclusion The clinical symptoms of patients with lung cancer are often atypical,and the misdiag-nosis rate is high.For patients with pneumonia or tuberculosis who have no response to anti-infection or anti-tuberculosis treatment,the possibility of lung cancer should be considered.It is recommended to strengthen physician training,optimize the diagnostic process,and introduce advanced detection methods,so as to confirm the diagnosis and provide aggressive treatment as soon as possi-ble,so as to improve the quality of life of patients.