Investigating The Effect Of Surgical Treatment And Study Of Tumor Marker Associated With Early Stage Small-cell Lung Cancer

Small cell lung cancer is a type of lung cancer and its incidence rate of 15-20%, and lung cancer is one of the world’s most common malignant tumor today. It has special biological characteristics, such as high malignant degree, fast mutiplication. It is easy to metastasis to regional lymph, distant organ and relapse, the patient prognosis is relatively poor. The median survival time is relatively short after treatment. The main treatment is comprehensive treatment. Surgery in the treatment of limited small cell lung cancer has been debated. The value of surgery is under debating in the medical field. At the same time the early diagnosis means of small cell lung cancer is no advanced. This article analyzes the laws by the retrospective investigation means, valuation of surgical treatment in the treatment of early stage small cell-lung cancer, characteristic of serum levels in early stage small-cell lung cancer serum tumor. To evaluate the regimens of three serum tumor markers in early stage small cell lung cancer diagnosis.Part 1 Investigating the effect of surgical treatment in early stage small-cell lung cancerObjective To analysis retrospectively the outcome of treatment in early stage small-cell lung cancer and definit its value.Methods Date is from previously untreated patients in Shandong Tumor Hospital between January 2006 to December 2009. The group of patients is 85 patients with 11 cases lost during follow-up and 74 cases of follow-up data is almost completed. All patients were confirmed as small cell lung cancer by pathology through surgery or biopsies. And they had comprehensive imaging data including head and chest enhanced CT, ultrasonography of neck and bdomen, bone scintigraphyg or PET-CT. The group was distributed clinical stage I and II by the 7th edition of the TNM staging of lung cance. Based on the different treatment options,38 patients were divided into group A(surgery plus adjuvant chemotherapy), and 36 patients were divided into group B (chemotherapy and radiotherapy); Surgical procedures including lobectomy and node dissection, lung wedge resection, full lobectomy and full lymphadenectomy; Intravenous chemotherapy including EP (etoposide^ cisplatin) or EC (etoposide、carboplatin); Thoracic radiotherapy including ordinary radiotherapy or conformal radiotherapy, a single dose of 1.8-2.0 Gy, a total dose of 55-60 Gy. Statistical analysis methods:Survival analysis using the Kaplan-Meier method. Survival rates between the two groups were compared using Log rank test (log-rank test).Results Early stage small cell lung cancer group with surgical treatment,1-year survival rate,3-year survival rate,5-year survival rate was 92.1%,60.5%,42.1%. while the non surgery group,1-year survival rate, the 3-year survival rate,5-year survival rate followed by 83.3%,38.9%,19.4%. The difference of their survival rate was remarkable, P<0.05. Early stage small cell lung cancer group with surgical treatment,1-year,2-year and 3-year progress free survival rates were78%,60.5% and 52.7%, while the non-surgery group,1-year and 3-year progress free survival rates were 75%,30.6% and 25%. The difference of their progress free survival was remarkable.Conclusion Surgery can improve early clinical stage small cell lung cancer survival and improve prognosis.Part 2 Clincal value of serum tumor markers in diagnosis of early-stage small cell lung cancerObjective In recent years, studies of lung cancer tumor markers continue to make progress and application to clinical practice, and has been emerged as one of the routine examination of lung cancer diagnosis. To evaluate the rules of three serum tumor markers in early stage small cell lung cancer diagnosis.Methods The patients were selected from Shandong Province Tumor Hospital from December 2009 to May 2014, and confirmed by pathology. According to staging post or tissue biopsy, head and chest enhanced CT, bone scan and PET-CT and other imaging findings. The clinical stage of lung cancer is determined based on the 7th edition TNM staging from 2009 UICC.75 patients with SCLC, including early atage SCLC Ⅰ, Ⅱ of total 35 cases. Advanced stage SCLC Ⅲ,Ⅳ of a total of 40 cases. NSCLC patients with stage Ⅰ, Ⅱ a total of 65 cases of lung squamous cell carcinoma in 38 cases,27 cases of lung adenocarcinoma.27 cases of benign lung lesions. All of the above objects into groups aged 19 to 75 years, mean age 53 years, without intestines, liver and kidney diseases and other tumor diseases. The serum levels of the three tumor markers(NSE,CEA,CYFRA21-1) were detected by ELISA in patients with lung cancer, and patients with respiratory infection, respectively.Results The sensitivity and levels of the NSE in patients with early-stage small cell lung cancer were obviously higher than those in patients with respiratory infection (P<0.0\). The sensitivity of the NSE in diagnosing early-stage small cell lung cancer was obviously higher than the CEA and CYFRA21-1 (P<0.01). Both the sensitivity of the CEA and the CYFRA21-1 in diagnosing early-stage squamous and lung adenocarcinoma was obviously higher than that in the early-stage small cell lung cancer (P<0.05).The sensitivity and levels of the NSE in patients with early-stage small cell lung cancer were obviously lower than those in advanced small cell lung cancer(P<0.05).Conclusion The NSE is a sensitive index for early-stage small cell lung cancer, and more sensitive than CEA and CYFRA21-1, clinically assisting in the diagnosis the of early-stage small cell lung cancer.