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与口腔鳞状细胞癌诊断延迟相关的因素。

Factors related to delay in diagnosis of oral squamous cell carcinoma.

作者信息

Gao Wei, Guo Chuan-Bin

机构信息

Outpatient Dental Center, Peking University School & Hospital of Stomatology, Beijing, People's Republic of China.

出版信息

J Oral Maxillofac Surg. 2009 May;67(5):1015-20. doi: 10.1016/j.joms.2008.12.022.

DOI:10.1016/j.joms.2008.12.022
PMID:19375011
Abstract

PURPOSE

Possible patient and professional factors related to delay in diagnosis of oral squamous cell carcinoma (OSCC) were investigated and analyzed.

MATERIALS AND METHODS

We collected patient data with a survey conducted by medical professionals through a questionnaire at one of the largest hospitals of stomatology in Beijing, China. Multiple logistic regression was applied to look for the correlation between patient delay and predictor variables: age, resident region, lesion site, primary signs and symptoms, and lesion size. A single-factor variance analysis was used to find the correlation between professional delay and other possible related clinical factors.

RESULTS

We investigated 102 consecutive patients with OSCC treated at the Department of Oral and Maxillofacial Surgery, Peking University Hospital of Stomatology, Beijing, China. Lesion site (P = .012) and maximal diameter of the lesion (P = .067) were inversely correlated with patient delay. Clinical variables such as whether biopsy was adopted at the initial clinical visit, length of time from the first clinical consultation to cytologic biopsy, the number of clinical departments in which patients were seen, and the necessity for any treatments before definitive diagnosis were significantly correlated with professional delay.

CONCLUSION

Lesions in the tongue and larger maximal diameter of the lesion caused longer patient delay in the diagnosis of OSCC. Whether biopsy was used at the initial management and its delay time were crucial factors to professional delay. Inappropriate clinical treatments before definitive diagnosis and the more referrals that the patient underwent prolonged the delay.

摘要

目的

对口腔鳞状细胞癌(OSCC)诊断延迟相关的患者及专业因素进行调查与分析。

材料与方法

我们通过问卷调查收集患者数据,该调查由医学专业人员在中国北京最大的口腔医院之一开展。应用多元逻辑回归分析来探寻患者延迟与预测变量之间的相关性,这些预测变量包括年龄、居住地区、病变部位、主要体征和症状以及病变大小。采用单因素方差分析来找出专业延迟与其他可能相关的临床因素之间的相关性。

结果

我们调查了在中国北京北京大学口腔医院口腔颌面外科接受治疗的102例连续的OSCC患者。病变部位(P = .012)和病变最大直径(P = .067)与患者延迟呈负相关。临床变量,如初次临床就诊时是否进行活检、从首次临床会诊到细胞学活检的时间长度、患者就诊的临床科室数量以及明确诊断前是否需要任何治疗,均与专业延迟显著相关。

结论

舌部病变和较大的病变最大直径导致OSCC诊断时患者延迟时间更长。初次治疗时是否使用活检及其延迟时间是专业延迟的关键因素。明确诊断前不适当的临床治疗以及患者接受的转诊次数越多,延迟时间就越长。

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