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Objective To explore the application value of 16-slice spiral CT on diagnosis of patients with small cell lung cancer.Materials and method Fifty-one patients with SCLC (fourty-two men and nine women aged 33-74 years, mean age 52.8 years)and one hundred-seven patients with NSCLC(seventy-four men and thirty-three women aged 28-86 years, mean age 56.3 years)were studied. CT images were acquired with a siemens sensation 16-slice spiral CT. The site, morphous,volume and densty of tumor were studied. The CT signs of bronch-obliterationg,obstructive atelectasis or obstructive pneumonia,mediastinal lymphadenectasis,mediastinal vascellum encroachment,R value and pleural effusion were nanalyzed using non-conditinal Logistic regression nanlysis. The volume of the tumor and the mediastinal lymph node by using VOLUME software. The sensibility and specificity of R value were calculated using ROC curve analysis The result was statisticsed using SPSS13.0.Result①The ratio of central type and oblong paralleling bronchi in SCLC was higher than NSCLC. Significant differences was found in two groups(p >0.05). No significant differences in the densty and volume of primary tumor was found in two groups(p > 0.05).②The SCLC with bronch-unobstruction、obstructive atelectasis or obstructive pneumonia、mediastinal lymphadenectasis,mediastinal vascellum encroachment,R value had significantly higher value than those in NSCLC, the statistical differences in two groups was significant (p <0.05).③No statistically significant difference in pleural effusion was found in two groups.④With ROC curve analysis, R value had high value in diagnosis of SCLC. If R 0.65 was taken as a threshold to diagnose SCLC , sensitivity,specificity,accuracy as(84.8%, 79.2%, 87.87%) ; If R 0.55 was taken, sensitivity,specificity,accuracy as(80.22%, 85.30%, 79.74%); If R 0.75 was taken, sensitivity,specificity,accuracy as(86.45%,73.12%, 81.64%).⑤The signs of bronch-obliterationg was negative correlation to the central SCLC(B=-1.473,p<0.05), R value and mediastinal vascellum encroachment were positive correlation to(B=2.712、1.936,p<0.05). The signs of R value and mediastinal vascellum encroachment were positive correlation to peripheral SCLC.(B=1.358,0.961,p<0.05)Conclusion The signs of oblong paralleling bronchi、bronch-unobstruction、mediastinal lymphadenectasis,lymphoid node syzygium,R > 0.65, non-obstructive atelectasis or obstructive pneumonia, mediastinal vascellum encroachment were In favor of diagnosis of SCLC, Among them, the highest value of the diagnostic was R value.
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