Small cell carcinoma of the lung laboratory tests: Difference between revisions

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__NOTOC__
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{{Small cell carcinoma of the lung}}
{{Small cell carcinoma of the lung}}
{{CMG}}
{{CMG}}; {{AE}}{{SH}}
==Overview==
==Overview==
The initial evaluation of patients with small cell lung cancer (SCLC) confirmed by histopathological findings include a [[complete blood count]] with differential, [[electrolytes]], [[liver function test]], [[calcium]] level, [[LDH]], [[BUN]], and [[creatinine]].<ref name=NCCN>[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref> These laboratory tests should also be performed to assess the response to the initial therapy.<ref name=NCCN>[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>
The initial evaluation of [[Patient|patients]] with small cell lung cancer (SCLC) confirmed by [[Histopathology|histopathological]] findings include a [[complete blood count]] with differential, [[electrolytes]], [[liver function test]], [[calcium]] level, [[LDH]], [[BUN]], and [[creatinine]].  These [[laboratory]] tests should also be performed to assess the response to the initial therapy.


==Laboratory Findings==
==Laboratory Findings==
===Biopsy===
The following [[Medical laboratory|laboratory]] tests must be ordered in all [[Patient|patients]] with SCLC during the initial evaluation as well as during the assessment of response to treatment following the initial [[therapy]]:<ref name="NCCN">[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>
The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor [[biopsy]].
 
In SCLC, the tumor cells are small and round, but they can sometimes be ovoid or spindle shaped.  They have a scant [[cytoplasm]] with a high mitotic count and a hyperchromatic [[nuclei]].  Nearly all SCLC are immunoreactive for [[keratin]], [[thyroid transcription factor 1]], and epithelial membrane antigen.  Neuroendocrine and neural differentiation result in the expression of molecules like dopa decarboxylase, [[calcitonin]], neuron-specific [[enolase]], [[chromogranin A]], [[CD56]] (also known as nucleosomal histone kinase 1 or neural-cell adhesion molecule), gastrin-releasing peptide, and [[insulin-like growth factor 1]].  One or more markers of neuroendocrine differentiation can be found in approximately 75% of SCLC.<ref name="NCI"> National Cancer Institute: PDQ® Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute.  Available at: http://www.cancer.gov/cancertopics/pdq/treatment/small-cell-lung/healthprofessional.</ref>
 
<div align="left">
<gallery heights="175" widths="175">
Image:Lung small cell carcinoma (1) by core needle biopsy.jpg|Histopathologic image of small cell carcinoma of the lung. CT-guided core needle biopsy. H & E stain.
Image:Lung small cell cancer 01.jpeg|Micrograph of a small-cell carcinoma of the lung showing cells with nuclear molding, minimal amount of cytoplasm and stippled chromatin. FNA specimen. Field stain.
Image:Lung small cell cancer 03.jpeg|Anaplastic (microcellular, oat cell) carcinoma from the lung.
</gallery>
</div>
 
<div align="left">
<gallery heights="175" widths="175">
Image:Lung small cell cancer 04.jpeg|Histopathologic image of small-cell carcinoma of the lung. CT-guided core needle biopsy.
Image:Lung small cell cancer 05.jpeg|Small cell carcinoma, pleural FNA.
</gallery>
</div>
 
===Laboratory Tests===
The following laboratory tests must be ordered in all patients with SCLC during the initial evaluation as well as during the assessment of response to treatment following the initial therapy:<ref name=NCCN>[http://www.nccn.org/professionals/physician_gls/f_guidelines_nojava.asp NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014] </ref>
* [[Complete blood count]] with differential
* [[Complete blood count]] with differential
** Low [[hemoglobin]], [[thrombocytopenia]], or [[leukopenia]] can be found if the metastatic cells infiltrated the [[bone marrow]].
** Low [[hemoglobin]], [[thrombocytopenia]], or [[leukopenia]] can be found if the metastatic cells infiltrated the [[bone marrow]].
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* [[Liver function test]]
* [[Liver function test]]
** Liver function test should be done as a baseline and will be monitored during treatment.  Liver enzymes can be elevated in [[metastasis]].
** Liver function test should be done as a baseline and will be monitored during treatment.  Liver enzymes can be elevated in [[metastasis]].
* [[LDH]]
* [[Calcium]] level
* [[Calcium]] level
** [[Hypercalcemia]] can be present in case of excessive production of [[parathyroid hormone]] as a [[paraneoplastic syndrome]].
** [[Hypercalcemia]] can be present in case of excessive production of [[parathyroid hormone]] as a [[paraneoplastic syndrome]].
* [[BUN]]
* [[BUN]]
* [[Creatinine]]
* [[Creatinine]]
*[[LDH]]
=== Tumor Markers ===
* Detection of [[tumor markers]] may allow the [[cancer]] to be detected at an early stage and may change the outlook of the disease.
* The following [[tumor markers]] have been found to be associated with small cell lung cancer:
**[[Chromogranin A]] (CgA)
** Pro-gastrin releasing peptide (ProGRP)
**[[Neuron-specific enolase]] (NSE; an γ-γ isoform of the ubiquitous [[enolase]] [[enzyme]])
**[[Cytokeratin]] 19


==References==
==References==

Latest revision as of 22:21, 4 September 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]

Overview

The initial evaluation of patients with small cell lung cancer (SCLC) confirmed by histopathological findings include a complete blood count with differential, electrolytes, liver function test, calcium level, LDH, BUN, and creatinine. These laboratory tests should also be performed to assess the response to the initial therapy.

Laboratory Findings

The following laboratory tests must be ordered in all patients with SCLC during the initial evaluation as well as during the assessment of response to treatment following the initial therapy:[1]

Tumor Markers

  • Detection of tumor markers may allow the cancer to be detected at an early stage and may change the outlook of the disease.
  • The following tumor markers have been found to be associated with small cell lung cancer:

References


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