Can small cell lung cancer be diagnosed?

In recent years, unfamiliar words such as small cell lung cancer often appear in our lives. Many patients who do not know about this disease are very afraid that it will not be cured. In fact, for patients with early small cell lung cancer, appropriate medication can control the disease. Let's find out whether small cell lung cancer can be diagnosed.

A chest X-ray is the simplest and most practical examination method. Chest computed tomography (CT) can show lesions that cannot be found by ordinary X-ray examinations, and can show the scope and degree of involvement of the hilar lymph nodes and mediastinum. Magnetic resonance imaging (MRI) is not as good as CT in finding small lesions in the lungs, but it can more clearly show the relationship between the tumor and large blood vessels. When determining whether there is intracranial metastasis, enhanced MRI is the first choice.

Positron emission tomography (PET) and whole-body PET are significantly more accurate than CT and radionuclide bone scans in identifying lung masses, lymph nodes or distant metastases. The positive rate of sputum cytology is related to the location and size of the tumor, the quality of sputum, and whether there is concurrent infection. The detection rate of central lung cancer is high, but it is difficult to determine the type, and it is currently not recommended.

Fiberoptic bronchoscopy can observe the location, size and extent of tumor infiltration in the bronchial cavity, and obtain tissue for pathological examination. Intrabronchial ultrasound is a new technology. For lesions with only airway compression but no intracavitary tumors, this examination can help clarify the extent of the lesion and improve the accuracy of transmural biopsy.

Percutaneous puncture lung biopsy is completed under the guidance of CT, with a biopsy positive rate of up to 90%. If the tumor contains a large area of ​​necrosis, it is often falsely negative. Mediastinoscopy can be considered for cases that are difficult to diagnose with conventional methods. It is of great significance for the diagnosis of upper mediastinal lymph node metastasis or anterior mediastinal lymph node invasion. Thoracoscopic and open-chest biopsy can be considered for peripheral lesions, mediastinal lesions or pleural lesions that are difficult to diagnose.

Ultrasound of superficial lymph nodes: SCLC is prone to metastasize to supraclavicular lymph nodes. Ultrasound scans of the neck, supraclavicular nodes, axillae, etc. are performed to determine the stage of lymph node metastasis. Abdominal ultrasound, CT or MRI: The liver and adrenal glands are sites where SCLC is prone to metastasize. Patients diagnosed at the first time should undergo abdominal imaging examinations to determine the stage.

Enhanced MRI of the head: Enhanced MRI is more sensitive to brain metastases than CT. Whole-body bone scan: If a whole-body bone scan indicates a high metabolic site, the patient's medical history should be carefully inquired, and combined with MRI to determine whether it is metastasis. Tumor marker examination: The main markers are NSE, CEA, SCC, CYFR21-1, etc., which lack specificity and have a certain reference value for disease monitoring. Finally, pathological examination is used to differentiate it from other types of lung cancer.