Clinical Diagnostic Value Of CT Scan And NSE Determination For SCLC

Backgroud: Lung cancer is the most frequent and lethal malignancy in the world. Lung cancer should be devided into small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC).The biologic behavior of SCLC is different from that of NSCLC.The treatment of SCLC alternatives with either chemotherapy or radiotherapy.So it's very important to diagnosis exactly.Objective:To investigate the clinic diagnosis value of CT scan combined with the determination of serum NSE for SCLC.To elevate the value of ability of recognize and diagnose of SCLC by medical imagine and molecular biology.Methods:103 consecutive patients with pulmonary lesions by CT scan,which suspiciously suffered lung cancer,were studied prospectively.Serum samples were obtained by venous puncture from all patients 1 week prior to surgery or puncture biopsy. The serum concentration of NSE were determinated using radio-immunity. According to the pathologic result , the diagnostic value of CT scan , NSE were evaluated.Spiral CT examinations were performed with a SIEMENS SOMATOM Emotion and PLUS 4helical scanner,some patients performed triphasic enhanced scan.Statistical analysis was executed by SPSS 13.0 software.The enumeration data of groups were compared using Kruskal-Wallis H test and Nemenyi test,significant level=0.05.Three diagnostic methods compared using ROC curve.Result:1.Most CT findings of SCLC were central and spindly or eggplant - shape mass,hilar and/or mediastinal lymph nodes enlargement.The obstructive pulmonary lesions were found rarely. 2.Using CT scan and NSE alone , the sensitivity were 78.6%, and 75.0%,the specificity were 76.0%and 73.3%,the accuracy were 76.7% and 72.8% respectively. With combination of CT scan and NSE,the diagnostic sensitivity was 89.3%, the specificity was 77.3%.,and the accuracy was 80.6% .Conclusion:1.SCLC has specific CT findings,CT scan was a reliable technique in the detection.2. The level of NSE in SCLC group was significantly higher than the NSCLC group and the benign pulmonary disease group,NSE may be a good tumor marker for the diagnosis of SCLC. 3.The sensitivity,specificity and accuracy would be increased by CT combined with serum tumor markers(NSE)in diagnosis of SCLC,and may be value to increase the total accuracy diagnostic rate.