以低钠血症为首发表现的小细胞肺癌误诊报告
摘要
目的探讨小细胞肺癌发生低钠血症的特点及误诊原因、防范措施。方法回顾分析我院收治的1例曾误诊为慢性胃炎的以低钠血症为首发表现的小细胞肺癌的临床资料。结果本例因呕吐、咳嗽1周,黑便5 d入院,曾就诊于当地2家医院,行胃镜检查诊断慢性胃炎,予相应治疗后发现持续存在呕吐及低钠血症,为明确病因转入我院消化内科,予抑酸及补钠等治疗,病情无明显缓解。考虑是否为抗利尿激素分泌不当综合征。因患者间断轻度咳嗽,胸部X线检查示心影后见片状影,进一步行胸部CT检查并取组织行病理检查,确诊为小细胞肺癌。患者及其家属拒绝手术治疗,自行出院,后失访。结论掌握小细胞肺癌临床特点,认真对病情进行分析,并尽快完善相关医技检查,可减少或避免其误诊。
引文
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[13]Oshita F,Sugiura M,Murakami S,et al.Phase II study of nedaplatin and irinotecan in patients with extensive small-cell lung cancer[J].Cancer Chemother Pharmacol,2013,71(2):345-350.
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[15]吴在德,吴肇汉.外科学[M].6版.北京:人民卫生出版社,2004:359.
[2]陈一天,徐益琛,陶累累,等.小细胞肺癌中MTA1蛋白的表达及其与化疗敏感性和预后的关系[J].临床肿瘤学杂志,2014(2):102-106.
[3]Mc Donald P,Lane C,Rojas G E,et al.Syndrome of inappropriate anti-diuretic hormone in non-small cell lung carcinoma:a case report[J].Ecancermedicalscience,2012,6:279.
[4]Nakazato Y,Imai K,Abe T,et al.Unpleasant sweet taste:a symptom of SIADH caused by lung cancer[J].J Neuro Neurosurg Psychiatry,2006,77(3):405-406.
[5]扈艳婷,王旭,马克威,等.老年小细胞肺癌合并抗利尿激素分泌不当综合征19例[J].中国老年学杂志,2014,34(3):793-794.
[6]Matsuura T.Hyponatremia in cancer patients[J].Nihon Jinzo Gakkai Shi,2012,54(7):1016-1022.
[7]古力巴哈尔·阿不都西.以首发表现为低钠血症的肺癌发病因素及误诊原因分析[J].新疆医学,2012,42(3):70-72.
[8]Onitilo A A,Kio E,Doi S A.Tumor-related hyponatremia[J].Clin Med Res,2007,5(4):228-237.
[9]淡冰,王强平,李鸿,等.去氨加压素致低钠血症引起癫痫持续状态1例[J].中国医学创新,2012,9(32):97-98.
[10]Radulescu D,Pripon S,Bunea D,et al.Endocrine paraneoplastic syndromes in small cell lung carcinoma.Two case reports[J].J BUON,2007,12(3):411-414.
[11]Hansen O,Sorensen P,Hansen K H.The occurrence of hyponatremia in SCLC and the influence on prognosis:a retrospective study of 453 patients treated in a single institution in a 10-year period[J].Lung Cancer,2010,68(1):111-114.
[12]马芳,刘先领,胡春宏,等.小细胞肺癌合并低钠血症的临床特点及预后分析[J].中南大学学报:医学版,2011,36(1):64-67.
[13]Oshita F,Sugiura M,Murakami S,et al.Phase II study of nedaplatin and irinotecan in patients with extensive small-cell lung cancer[J].Cancer Chemother Pharmacol,2013,71(2):345-350.
[14]Hermes A,Waschki B,Reck M.Hyponatremia as prognostic factor in small cell lung cancer--a retrospective single institution analysis[J].Respir Med,106(6):900-904.
[15]吴在德,吴肇汉.外科学[M].6版.北京:人民卫生出版社,2004:359.