Effects on distant metastasis of misdiagnosis of nasopharyngeal carcinoma.
- Author:
Ligen MO
1
;
Guoqian KUANG
;
Guangwu HUANG
;
Rongning YANG
Author Information
1. Department of Head and Neck Surgery, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, 530021, China. ligenmo@163.com
- Publication Type:Journal Article
- MeSH:
Diagnostic Errors;
Humans;
Nasopharyngeal Neoplasms;
diagnosis;
pathology;
therapy;
Neoplasm Metastasis;
Neoplasm Staging;
Prognosis;
Retrospective Studies;
Treatment Outcome
- From:
Journal of Clinical Otorhinolaryngology Head and Neck Surgery
2007;21(24):1124-1126
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the effects of situation of misdiagnosis of nasopharyngeal carcinoma (NPC) on distant metastasis.
METHOD:The history of diagnosis and treatment of 85 newly diagnosed cases with nasopharyngeal carcinoma were studied by using itemized questionnaire purposely; 433 patients with different prognosis were analyzed retrospectively for the misdiagnoses and mistreatment, including surgical biopsy in the neck.
RESULT:(1) The rate of misdiagnosis of 85 patients was 72.64%, and the percentage decreased as the level of the hospitals increased; the majority of the patients (77.36%) were diagnoses within 1 month after the first symptom had appeared; the number of diseases misdiagnosed was 20, most common of which were lymphnoditis, tuberculosis of lymph node and secretory tympanitis; (2) Our data showed that among 433 patients analysed retrospectively, 60 cases had undergone surgical biopsy in the neck, 75% of whom had never received nasopharyngeal biopsy; 43 cases had underwent nasopharyngeal biopsy after the pathological diagnosis as metastatic carcinoma of neck biopsy (71.67%) and the rest (20.0%) received radiotherapy directly or after negative nasopharyngeal biopsy for merely 1 to 4 times; of those 43 cases who were diagnosed as NPC by nasopharyngeal biopsy, 79.17% got positive results at first sampling. (3) Rate of misdiagnosis and mistreatment including surgical biopsy in the neck of patients who had been tumor-free for 5 years or above was significantly lower than that of those who experienced distant metastasis after or before treatment (P < 0.05).
CONCLUSIONS:Misdiagnosis and mistreatment including biopsy by surgery of neck is common even in high-grade hospitals; it is doctor that is responsible for this situation; the high occurrence rate of misdiagnosis and mistreatment, biopsy by neck surgery, especially the delayed treatment after the neck biopsy are the factors that contribute to distant metastasis of NPC.
