Abstract
OBJECTIVE: To explore the characteristics of the ploidy status of Small Cell Lung Cancer (SCLC) cells and assesses its efficacy in cytopathological diagnosis of SCLC. METHODS: A retrospective analysis was performed on patients who agreed to DNA image cytometry (DNA ICM) and serum tumor biomarker testing. Samples for ploidy assessment, all from bronchial procedures, were analyzed using DNA ICM. Data on demographic features, pathological characteristics, staging results, biomarkers such as neuron specific enolase (NSE) and Pro-gastrin-releasing peptide (ProGRP) data, and ploidy status across different groups were collected. Corresponding statistical analyses were conducted to examine differences in aneuploid status among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of DNA ICM and tumor markers for diagnosing SCLC. RESULTS: A total of 74 patients with SCLC, 108 patients with NSCLC, and 74 patients with benign lesions were included. The age range of all patients was 26 to 85 years, with 69% being male and 31% female. In terms of ploidy status, single aneuploid cell peaks and double aneuploid peaks were observed in both SCLC and NSCLC groups. The proportions of two types of aneuploid cell peaks differed significantly between the two groups (P=0.008). The aneuploid cell ratio showed a high accuracy for small-cell lung cancer, with a sensitivity of 91.2% and a specificity of 88.1%. There was no statistical difference in ploidy status between limited and extensive stages of SCLC. As for biomarkers, the AUC (area under the curve) values were 0.921 for NSE and 0.928 for ProGRP, with a significant difference in NSE between two stages of SCLC (P=0.015), while no significant difference was observed in ProGRP. CONCLUSION: Aneuploid cell peaks in SCLC patients are mostly distributed in the near triploid range, possibly serving as a specific cytological marker for SCLC. DNA ICM is a highly sensitive tool that may be an adjunct for SCLC diagnosis.