The Application Of Tumor Markers And MRI In Brain Cancer Metastased From Small Cell Lung Cancer

Objevtive:To Research the biological characteristics of serum ProGRP and NSE,and clinical significance of SCLC with brain metastases diagnosis, effect evaluation. Combine brain MRI, to discuss the correlation between two methods and sensitivity joint inspection, it will provide the scientific basis for SCLC with brain metastases of clinical diagnosis and treatment.Methods:728cases of lung cancer with complete clinical data during-February-2009--February-2012period in respiratory, thoracic surgery, radiation therapy from Shanxi Tumor Hospital were collected, and, and were confirmed by histopathology and cytology. With SCLC patients368cases,360patients with NSCLC and health control group300cases, using the ELISA and ECLIA to detect cases of brain cancer metastased from lung cancer and lung cancer before and after treatment and healthy controls ProGRP, NSE serum levels, and collection of brain metastases from lung cancer cases brain MRI information, ADC of DWI.SPSS16.0software package was applied to process statistically.Results:The serum ProGRP median value of368cases of SCLC patient was618.6pg/ml, the sensitivity was77.7%, the median value of NSE was40.4μg/L, the sensitivity was61.4%, and both the detection sensitivity was86.9%, were significantly higher than in NSCLC group and healthy control group, with significant difference after statistics processing,(p＜0.05). The serum ProGRP median value of169cases of brain cancer metastased from SCLC was2664.6pg/ml, positive rate was98.2%, the median value of NSE was48.8μg/L, positive rate was70.4%, were significantly higher than in brain metastasis group from NSCLC, with significant difference after statistics processing,(p＜0.05).199SCLC not brain metastasis cases serum ProGRP median514.3pg/ml, positive rate was71.9%, the NSE of the median value of40.41mu g/L, the positive rate is64.8%. brain metastases group from SCLC were significantly higher than those without brain metastasis group, with significant difference after statistics processing,(p＜0.05). brain metastasis group from SCLC of craniocerebral MRI detected795lesions, performance, long and mixed signals, such as T1WI sequence T2WI sequence, such as long and the image characteristics of mixed signal is given priority to, comply with the general imaging characteristics of brain metastases, including DWI imaging sequence can in169cases with brain metastases from SCLC and131cases of NSCLC lesion of brain metastasis detection rate was96.7%and28.6%respectively, the statistical comparison, there is significant difference (p＜0.05). ProGRP, NSE, DWI, ProGRP+DWI, NSE+DWI in68cases of brain metastases from SCLC suspicious cases can the sensitivity of the diagnosis were80.4%,41.2%,66.7%,92.2%,66.7%, specific degrees were52.9%,35.3%,76.5%,94.1%,76.5%. ProGRP+DWI and NSE+DWI detection sensitivity and specific degree were higher than individual, the difference was statistically significant (p＜0.05).156cases of patients with brain metastases from SCLC WBRT rADC values before and after lesions, ProGRP and NSE levels, according to with the improvement of lesions, rADC value is on the rise, ProGRP presents downtrend and NSE level,(r=-0.945,p＜0.05) on the other hand, with the progress of the lesion, rADC value is on the decline, ProGRP and NSE levels rise (r=-0.995,p＜0.05), rADC values and negatively correlated with ProGRP and NSE level.Conclusions:The detection of ProGRP and NSE combination with MRI be used as diagnosis for SCLC with brain metastatic, provide objective basis and clinical guidance for WBRT effect evaluation...