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本文通过58例肺癌临床资料分析,对其中32例误诊病例进行讨论,在32例误诊病例中误诊为肺结核者18例,肺炎者10例,结核性胸膜炎和粟粒性肺结核者各2例。整个误诊率高达55%。误诊原因包括对常见症状的忽略。为既往肺结核病史所掩盖,对癌性胸水错误认识以及对各种各样的不典型X线表现等多种因素。为了提高肺癌的早期诊断水平,减少误诊,提出对年龄在40岁以上的中老年人,特别是吸烟史以及肺结核病史的患者,临床上出现干性呛咳,痰少或血痰等呼吸系统症状时,经合理的抗结核治疗后症状加剧,病灶扩大,应高度怀疑肺癌的存在。实验室检查有助于肺癌的早期诊断,痰脱落细胞纤支镜检查,阳性率可达80～90%以上。结核菌素试验阴性者对诊断肺癌也有帮助,应尽早选用。
In this paper, 58 cases of lung cancer clinical data analysis, of which 32 were misdiagnosed cases were discussed in 32 cases of misdiagnosed cases of misdiagnosed as tuberculosis in 18 cases, 10 cases of pneumonia, tuberculous pleurisy and miliary tuberculosis in 2 cases. The entire misdiagnosis rate as high as 55%. Causes of misdiagnosis include the neglect of common symptoms. To cover the history of previous tuberculosis, false recognition of cancerous pleural effusion and a variety of atypical X-ray manifestations and other factors. In order to improve the early diagnosis of lung cancer and reduce the misdiagnosis, the paper presents the diagnosis of respiratory symptoms such as dry cough, phlegm or bloody sputum in middle-aged and elderly people over the age of 40, especially in the history of smoking and pulmonary tuberculosis , After reasonable treatment of anti-TB symptoms worsened, enlarged lesions, should be highly suspected of the existence of lung cancer. Laboratory tests contribute to the early diagnosis of lung cancer, sputum exfoliated cell bronchoscopy, the positive rate of up to 80 to 90%. Tuberculin test negative for the diagnosis of lung cancer is also helpful, should be used as soon as possible.