The Clinical Analysis Of 21 Small Cell Lung Cancer With Paraneoplastic Syndrome As Initial Symptom

ObjectiveTo investigate the clinical characteristics of small cell lung cancer(SCLC) with paraneoplastic syndrome as initial symptom,in order to improve the understanding of the clinical manifestations of lung cancer in the clinical doctor.It will be helpful to the early diagnosis of small cell lung cancer and reduce the misdiagnosis rate. MethodsThe clinical data of 21 cases of lung cancer with paraneoplastic syndrome as initial symptom were analyzed from Jan1 st, 2010 to Jan1 st, 2015 in the hospital. Results(1)Among the patients with SCLC in the hospital, 6.6%(21/318) had paraneoplastic syndrome as initial symptom.The ratio of male to female was 2.5:1(15:6).There were 17 cases aged above 21(81.0%)and 11 with smoking history(52.4%).(2)The patients with paraneoplastic syndrome included:8cases of osteoarthropathy(38.1%) which include 3 hypertrophic osteoarthropathy(14.3%), 3 clubbed-finger(14.3%) and 2 hypertrophic osteoarthropathy combined finger clubbing(9.52%); 4 cachexia(19.0%) which include 1 myasthenia(4.76%) and 3 sensory nerve dysfunction(14.3%); 5 Ectopic endocrine disorder(23.8%) which include 2 ectopic adrenocorticotropic hormone syndrome(9.52%);1 abnormality of inappropriate secretion of antidiuretichormone(4.76%)and 2 gynecomastia(9.52%);4 paraneoplastic dermatoses(19.0%) which include 2 acanthosis nigricans(9.52%) and 2 cutaneous pigmentation(9.2%).(3)The misdiagnosis rate of the first consultation was 76.2 %(16/ 21).(4)Initial chest X-ray positive rate and Initial CT positive rate was 81.0 %(17/21).(5)After the diagnosis of small cell lung cancer using EP solution manifest paraneoplastic syndrome. Conclusion(1)incidence rate of SCLC with paraneoplastic syndrome as initial symptom is not high, It is difficult to diagnose because of its latent onset. The misdiagnosis rate is high.(2)SCLC with paraneoplastic syndrome as initial symptom was more likely to happen in men.(3)X-ray or CT examination can check SCLC with paraneoplastic syndrome as initial symptom out easily which helps the diagnosis in early stage.(4)EP regimen chemotherapy reliefs SCLC with paraneoplastic syndrome obviously which can be used as the most effective method.