Small cell carcinoma of the lung laboratory tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

Biopsy

The confirmation of the diagnosis of SCLC relies on the histopathological findings of the tumor biopsy.[1]

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.[2]

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:[1]

References

  1. 1.0 1.1 NCCN Clinical Practice Guidelines in Oncology. Small Cell Lung Cancer, version 2.2014
  2. 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.


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