30例首发肺外表现肺癌研究.docVIP

30例首发肺外表现肺癌研究[摘要] 目的 提高对以肺外表现为首发症状的肺癌的认识。方法 回顾性分析30例以肺外表现为首发症状的肺癌的临床资料。结果 30例有肺外表现的肺癌均经病理诊断证实,诊断时间3～120d;表现为肥大性骨关节病16例,腹泻1例,血糖升高3例,男性乳腺增生3例,肌病4例,老年痴呆1例,无力、全身抽搐2例。其中6例伴干咳,10例伴不同程度的体重下降,2例伴发热。30例X线检查均发现肺部阴影。病理诊断鳞癌14例,腺癌12例,小细胞未分化癌4例。结论 肺外表现为首发临床表现的肺癌易误诊为其他系统疾病,临床上须提高警惕。 [关键词] 肺癌;肺外表现;副癌综合征 [中图分类号] R734.2 [文献标识码] A [文章编号] 1673-9701(2009)36-145-02 Lung Cancer with Extrapulmonary Manifestation as the First Symptom:A Clinical Analysis of 30 Cases WANG LinmeiXIA XizhengGAO Yuanxun Department of Respiratory,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China [Abstract] Objective To improve the awareness of lung cancer with extrapulmonary manifestation as the first symptom. Methods A retrospective analysis was made of all clinical data of 30 patients with extrapulmonary manifestation as the first symptom of lung cancer. Results All 30 cases of lung cancer with extrapulmonary manifestation as the first symptom were confirmed by pathology in 3-120 days. 16 cases showed hypertrophic osteoarthropathy,1 case diarrhea,3 cases hyperglycemia,3 cases gynecomastia,4 cases myopathy,2 cases malaise or convulsions and only one case Alzheimer. 10 cases had weight loss and fever occurred in 2 cases at the same time. X-ray showed all cases had lung shadow,14 cases were squamous carcinoma,12 cases adenocarcinoma and4 cases small cell undifferentiated carcinoma. Conclusion We should pay more attention to lung cancer with extrapulmonary manifestation as the first symptom to avoid misdiagnosis. [Key words] Lung cancer;Extrapulmonary manifestation;Paraneoplastic syndrome 肺癌为当前世界各地最常见的恶性肿瘤之一。当肺癌首发肺外表现时易被误诊。现总结我科近10年收治以肺外表现为首发症状的肺癌30例,报道如下。 1临床资料 1.1一般资料 30例均为住院病例,男性24例,女性6例,年龄19~66岁。所有肺外症状均除外肿瘤转移、压迫及可能导致副癌综合征症状的其他疾病。 1.2临床表现 本组病例最初表现为肺性骨关节病者16例;10例单纯表现为杵状指;2例为肩关节疼痛,活动受限;4例表现为膝、踝、肘和掌指关节疼痛,肿胀,多为对称性;3例乳房肿大,1例为乳房肿大伴疼痛;3例血糖升高,尿糖;4例为进行性肌无力;2例表现为严重乏力或间断全身抽搐,查电解质为低钠、低钾血症;1例间断水样腹泻;1例进行性痴呆。30例中6例患者起病以来伴有不同程度的咳嗽,2例伴低热,10例出现体重下降。 2结果 2.1X