Yaman Nesrin, Ozgen Aylin, Celik Pinar, Ozyurt Beyhan Cengiz, Nese Nalan, Coskun Aysin Sakar, Yorgancioglu Arzu
Department of Pulmonary Diseases, Celal Bayar University School of Medicine, Manisa, Turkey.
Tumori. 2009 Nov-Dec;95(6):702-5. doi: 10.1177/030089160909500611.
We aimed to investigate the factors affecting the interval from the beginning of the symptoms until diagnosis and treatment in patients with lung cancer.
Records of 119 lung cancer patients diagnosed in our pulmonary diseases clinic between 2004 and 2006 were evaluated retrospectively. Demographic data, histopathological tumor type, TNM stage, ECOG performance status, presence of endobronchial lesions, and radiological localization of the tumor were determined. Intervals from the first symptom to contacting a doctor, to diagnosis and to treatment were calculated. The interval from first admission to a clinic and referral to a chest physician was also calculated.
Of 119 patients, 74% were diagnosed as non-small cell and 26% were as small cell lung cancer. Forty-eight percent of the patients were at stage 3B and 36% were at stage 4. ECOG performance status was 0 in 6%, 1 in 52%, 2 in 36%, 3 in 3%, and 4 in 2%. Endobronchial lesions were observed in 50% of the patients, and the lesions had a central radiological localization in 59%. Fifty-four percent of the patients presented to a chest physician first. Patients who first presented to an internal medicine clinic were referred to our pulmonary disease clinic significantly later than those who presented to other clinics (P = 0.005). The median period from the beginning of the symptoms until contacting a doctor was 35 days (range, 1-387), until diagnosis was 49 days (range, 12-396), and until beginning the treatment was 57 (range, 9-397) days. The presence of endobronchial lesions, radiological localization, TNM stage and ECOG performance status were not found to be related to the intervals from the first symptom to presentation to a doctor, to diagnosis or to the beginning of the treatment.
Lung cancer patients consult a doctor after a relatively long symptomatic period. Patient delays may be shortened by increasing the awareness of patients about lung cancer symptoms. Diagnostic procedures should be performed more rapidly to shorten doctor delays.
我们旨在调查影响肺癌患者从症状出现到诊断及治疗的时间间隔的因素。
回顾性评估2004年至2006年期间在我们肺病诊所确诊的119例肺癌患者的记录。确定人口统计学数据、组织病理学肿瘤类型、TNM分期、东部肿瘤协作组（ECOG）体能状态、支气管内病变的存在情况以及肿瘤的放射学定位。计算从首次症状出现到就医、诊断及治疗的时间间隔。还计算了从首次就诊于某诊所到转诊至胸科医生的时间间隔。
119例患者中，74%被诊断为非小细胞肺癌，26%为小细胞肺癌。48%的患者处于3B期，36%处于4期。ECOG体能状态为0的患者占6%，为1的占52%，为2的占36%，为3的占3%，为4的占2%。50%的患者观察到支气管内病变，其中59%的病变具有中央放射学定位。54%的患者首先就诊于胸科医生。首次就诊于内科诊所的患者转诊至我们肺病诊所的时间明显晚于就诊于其他诊所的患者（P = 0.005）。从症状出现到就医的中位时间为35天（范围，1 - 387天），到诊断为49天（范围，12 - 396天），到开始治疗为57天（范围，9 - 397天）。未发现支气管内病变的存在、放射学定位、TNM分期及ECOG体能状态与从首次症状出现到就医、诊断或开始治疗的时间间隔相关。
肺癌患者在出现症状较长时间后才就医。可通过提高患者对肺癌症状的认识来缩短患者延误。应更迅速地进行诊断程序以缩短医生延误。
