Comparative Study Of CT Images Of Advanced Small Cell Lung Cancer And Non-Small Cell Lung Cancer

Objective:(1)To compare the unresectable advanced(?+?)MSCT manifestations of small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC),and to explore their respective signs and differential diagnosis value.(2)To explore the value of CT texture analysis in distinguishing unresectable small cell lung cancer(SCLC)from non-small cell lung cancer(NSCLC).Methods:Retrospective analysis of patients with grade ? and ? SCLC(90 cases)and NSCLC(88 cases,60 cases of squamous cell carcinoma,28 cases of adenocarcinoma)confirmed by pathology in our hospital from 2011 to 2018.(1)Statistical analysis was performed on the two groups of advanced MSCT signs.The morphological differences between the two groups were compared by two independent samples t test.(2)CT texture features(Mean?Skewness?Entrop?SumEntrp?DifEntrp?Kurtosis?ASM?Correlate)were meatured by Mazda software based onplain and enhanced CT images.The texture values between groups were compared using two independent samples t-test.The ROC(receiver operating characteristic)curve was used to evaluate the diagnostic efficiency.The correlation between texture values and pathological types was analyzed by Spearman rank test.Results:(1)The volume of primary lung in stage ? and ? SCLC group was smaller than swollen lymph node,lymph node enlargement/fusion,"lung portal + mediastinal expansion" type,pleural effusion,large vessel invasion,"map-like" enhancement,distant metastasis The probability of "NS-like" enhancement and cavitation was higher in the NSCLC group than in the NSCLC group(P<0.05).However,there was no significant difference in the incidence of bronchial stenosis and pleural/pulmonary metastasis between the two groups.(P>0.05).(2)Mean,Skewness,Entrop,SumEntrp,and DifEntrp values of the plain image in NSCLC were larger than those in SCLC(P<0.05).There were no significant differences in the Kurtosis,ASM and Correlate values(all P>0.05).The Mean value from arterial phase in SCLC was higher than the Mean value in NSCLC(P<0.05),and other texture parameters from enhanced images were not statistically significant(all P>0.05).The r values of of the Mean,Entropy,SumEntrp,and DifEntrp with pathological type were0.470,0.567,0.492,and 0.532,respectively(P < 0.05).ROC curve analysis showed that the Entropy in differentiating the two groups had the best diagnostic efficiency.The AUC value was 0.872,with a boundary value of 0.532,sensitivity of 99.4%,specificity of71.70%,accuracy of 84.09%,and AUC of Mean of arterial phase,the value was 0.723,with a cutoff value of 0.518,a sensitivity of 70.00%,a specificity of 81.80%,and accuracy of 78.50%.?Conclusion:There are some differences in the CT morphology of stage ? and ? SCLC and NSCLC,which can provide some reference value for the differential diagnosis of lung cancer in two groups;For the inoperable stage ? and ? SCLC and NSCLC,the five texture eigenvalues of the plain scan and the texture eigenvalue of the enhanced scanning arterial phase were statistically significant,which could provide a differential diagnosis for the two groups of lung cancer.New non-invasive methods,especially for some image signs lacking typical performance.The combination of the two methods can furtherimprove the ability to differentiate between SCLC and NSLC,and provide a reliable basis for the choice of clinical treatment options.